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Lazaridou A, Paschali M, Bernstein C, Curiel M, Moore S, Edwards RR. sEMG Biofeedback for Episodic Migraines: A Pilot Randomized Clinical Trial. Appl Psychophysiol Biofeedback 2024; 49:271-279. [PMID: 38280149 DOI: 10.1007/s10484-023-09615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/29/2024]
Abstract
The aim of this study was to assess the feasibility and potential effectiveness of a 6-week virtual sEMG biofeedback intervention for patients with episodic migraines. Patients with episodic migraines were randomized to treatment with a novel surface EMG (sEMG) at-home biofeedback device or a treatment as usual control group; they completed validated baseline and post-intervention assessments of migraine related disability (migraine-specific quality of life, anxiety and depression). Participants also underwent a series of Quantitative Sensory Testing (QST) procedures referring to several different tests that quantitatively assess responses to mechanical stimuli during two separate visits (baseline and post intervention). No adverse events were reported during the study. Compared to the treatment as usual comparison group, patients in the sEMG biofeedback group reported lower migraine disability (p < 0.05). Compared to baseline, participants in the sEMG biofeedback group demonstrated statistically significant reductions in anxiety (p < 0.01), and significant increases in quality of life (p < 0.001), and significant decreases in temporal summation (p < 0.05) assessed by QST. No significant changes were observed in any of the outcomes in the control comparison group (p > 0.05). No significant changes were observed in migraine frequency in either of the two groups (p > 0.05). In addition, mediation analyses revealed that changes in migraine related quality of life mediated group effects on changes in migraine disability. Virtual sEMG biofeedback shows promise as a potential therapy for reducing disability, anxiety and depression and improving quality of life in individuals with episodic migraines. These results demonstrate the feasibility of a digital intervention for migraines and set the basis for conducting a future, larger scale randomized controlled trial to confirm these preliminary findings.
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Affiliation(s)
- Asimina Lazaridou
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA.
- Fielding Graduate University, Santa Barbara, CA, USA.
| | - Myrella Paschali
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Carolyn Bernstein
- Department of Neurology, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Marie Curiel
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Sara Moore
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
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Buse DC, Nahas SJ, Stewart W(BF, Armand CE, Reed ML, Fanning KM, Manack Adams A, Lipton RB. Optimized Acute Treatment of Migraine Is Associated With Greater Productivity in People With Migraine: Results From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. J Occup Environ Med 2023; 65:e261-e268. [PMID: 36701797 PMCID: PMC10090340 DOI: 10.1097/jom.0000000000002801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study aimed to ascertain whether level of optimization of acute treatment of migraine is related to work productivity across the spectrum of migraine. METHODS Data were from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study, an internet-based longitudinal survey. Respondents with migraine who reported full-time employment and use of ≥1 acute prescription medication for migraine were included. We determined relationships among lost productive time (LPT; measured with the Migraine Disability Assessment Scale), acute treatment optimization (Migraine Treatment Optimization Questionnaire- ), and monthly headache days (MHDs). RESULTS There was a direct relationship between LPT and MHD category. Greater acute treatment optimization was associated with lower total LPT, less absenteeism, and less presenteeism within each MHD category. CONCLUSIONS Optimizing acute treatment for migraine may reduce LPT in people with migraine and reduce indirect costs.
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Lipton RB, Pozo-Rosich P, Blumenfeld AM, Li Y, Severt L, Stokes JT, Creutz L, Gandhi P, Dodick D. Effect of Atogepant for Preventive Migraine Treatment on Patient-Reported Outcomes in the Randomized, Double-blind, Phase 3 ADVANCE Trial. Neurology 2023; 100:e764-e777. [PMID: 36396451 PMCID: PMC9984220 DOI: 10.1212/wnl.0000000000201568] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The oral calcitonin gene-related peptide receptor antagonist atogepant is indicated for the preventive treatment of episodic migraine. We evaluated changes in patient-reported outcomes with atogepant in adults with migraine. METHODS In this phase 3, 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group trial (ADVANCE), adults with 4-14 migraine days per month received atogepant (10, 30, or 60 mg) once daily or placebo. Secondary endpoints included changes from baseline in Migraine-Specific Quality-of-Life Questionnaire (MSQ) version 2.1 Role Function-Restrictive (RFR) domain at week 12 and mean monthly Activity Impairment in Migraine-Diary (AIM-D) Performance of Daily Activities (PDA) and Physical Impairment (PI) domains across the 12-week treatment period. Exploratory endpoints included change in MSQ Role Function-Preventive (RFP) and Emotional Function (EF) domains; AIM-D total scores; and change in Headache Impact Test (HIT)-6 scores. RESULTS Of 910 participants randomized, 873 comprised the modified intent-to-treat population (atogepant: 10 mg [n = 214]; 30 mg [n = 223]; and 60 mg [n = 222]; placebo [n = 214]). All atogepant groups demonstrated significantly greater improvements vs placebo in MSQ RFR that exceeded minimum clinically meaningful between-group difference (3.2 points) at week 12 (least-square mean difference [LSMD] vs placebo: 10 mg [9.9]; 30 mg [10.1]; 60 mg [10.8]; all p < 0.0001). LSMDs in monthly AIM-D PDA and PI scores across the 12-week treatment period improved significantly for the atogepant 30 (PDA: -2.54; p = 0.0003; PI: -1.99; and p = 0.0011) and 60 mg groups (PDA: -3.32; p < 0.0001; PI: -2.46; p < 0.0001), but not for the 10 mg group (PDA: -1.19; p = 0.086; PI: -1.08; p = 0.074). In exploratory analyses, atogepant 30 and 60 mg were associated with nominal improvements in MSQ RFP and EF domains, other AIM-D outcomes, and HIT-6 scores at the earliest time point (week 4) and throughout the 12-week treatment period. Results varied for atogepant 10 mg. DISCUSSION Atogepant 30 and 60 mg produced significant improvements in key patient-reported outcomes including MSQ-RFR scores and both AIM-D domains. Nominal improvements also occurred for other MSQ domains and HIT-6, reinforcing the beneficial effects of atogepant as a new treatment for migraine prevention. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov NCT03777059. Submitted: December 13, 2018; First patient enrolled: December 14, 2018. CLINICALTRIALS gov/ct2/show/NCT03777059. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that daily atogepant is associated with improvements in health-related quality-of-life measures in patients with 4-14 migraine days per month.
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Affiliation(s)
| | | | | | - Ye Li
- From the Albert Einstein College of Medicine and the Montefiore Headache Center (R.B.L.), Bronx, NY; Headache Unit, Neurology Department (P.P.-R.), Vall d'Hebron University Hospital, Barcelona; Headache Research Group, VHIR (P.P.-R.), Universitat Autonoma of Barcelona, Barcelona, Spain; Headache Center of Southern California (A.M.B.), Carlsbad, CA; AbbVie (Y.L., L.S., J.T.S., P.G.), Madison, NJ; Peloton Advantage LLC, an OPEN Health Company (L.C.), Parsippany, NJ; and Department of Neurology (D.W.D.), Mayo Clinic, Scottsdale, AZ.
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Wang Y, Wang Y, Yue G, Zhao Y. Energy metabolism disturbance in migraine: From a mitochondrial point of view. Front Physiol 2023; 14:1133528. [PMID: 37123270 PMCID: PMC10133718 DOI: 10.3389/fphys.2023.1133528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Migraine is a serious central nervous system disease with a high incidence rate. Its pathogenesis is very complex, which brings great difficulties for clinical treatment. Recently, many studies have revealed that mitochondrial dysfunction may play a key role in migraine, which affects the hyperosmotic of Ca2+, the excessive production of free radicals, the decrease of mitochondrial membrane potential, the imbalance of mPTP opening and closing, and the decrease of oxidative phosphorylation level, which leads to neuronal energy exhaustion and apoptosis, and finally lessens the pain threshold and migraine attack. This article mainly introduces cortical spreading depression, a pathogenesis of migraine, and then damages the related function of mitochondria, which leads to migraine. Oxidative phosphorylation and the tricarboxylic acid cycle are the main ways to provide energy for the body. 95 percent of the energy needed for cell survival is provided by the mitochondrial respiratory chain. At the same time, hypoxia can lead to cell death and migraine. The pathological opening of the mitochondrial permeability transition pore can promote the interaction between pro-apoptotic protein and mitochondrial, destroy the structure of mPTP, and further lead to cell death. The increase of mPTP permeability can promote the accumulation of reactive oxygen species, which leads to a series of changes in the expression of proteins related to energy metabolism. Both Nitric oxide and Calcitonin gene-related peptide are closely related to the attack of migraine. Recent studies have shown that changes in their contents can also affect the energy metabolism of the body, so this paper reviews the above mechanisms and discusses the mechanism of brain energy metabolism of migraine, to provide new strategies for the prevention and treatment of migraine and promote the development of individualized and accurate treatment of migraine.
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Affiliation(s)
- Yicheng Wang
- Department of Neurology, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yongli Wang
- Department of Neurology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China
| | - Guangxin Yue
- Institute of Basic Theory for Chinese Medicine, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yonglie Zhao
- Department of Neurology, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Yonglie Zhao,
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Velásquez-Rimachi V, Chachaima-Mar J, Cárdenas-Baltazar EC, Loayza-Vidalon A, Morán-Mariños C, Pacheco-Barrios K, Posso M, Alva-Díaz C. Greater occipital nerve block for chronic migraine patients: A meta-analysis. Acta Neurol Scand 2022; 146:101-114. [PMID: 35726455 DOI: 10.1111/ane.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/05/2022] [Accepted: 05/01/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Greater occipital nerve block (GONB) is a minimally invasive procedure frequently used in patients with chronic migraine (CM); however, the quality of the evidence supporting its use is still unknown. Therefore, we aimed to conduct a systematic review, meta-analysis and quality assessment of GONB local anaesthetics combined or not with corticosteroids to prevent CM. METHODS We searched Medline, Scopus and Web of Science up to October 2020. We included randomized control trials (RCT) and observational studies assessing GONB without language restrictions. Two researchers selected the studies, extracted the data and evaluated the risk of bias independently. The primary outcomes measured to assess efficacy were the change from baseline in the intensity and frequency of headache in the intervention group compared to placebo at a onetime point. We performed a meta-analysis with random effect models, and we evaluated random errors with trial sequential analysis (TSA). We assessed the risk of bias (ROB) with the ROB2 tool and the certainty of the evidence with GRADE. RESULTS We identified 2864 studies in the databases and included three RCTs for quantitative synthesis. Most ROB assessments were 'high risk' or 'some concerns'. GONB reduced the intensity of headaches at the end of the first month (MD: -1.35, 95% CI: -2.12 to -0.59) and the second month (MD: -2.10, CI 95%: -2.94 to -1.26) as well as the frequency of headaches (first month: MD: -4.45 days, 95% CI: -6.56 to -2.34 days; second month: MD: -5.49, 95% CI -8.94 to -2.03 days). Corticosteroids did not show a significant decrease in the frequency of headaches during the first month of treatment (MD: -1.1 days, 95% CI: -4.1 to 1.8, p = .45). Included trials reported similar adverse events between groups. The exploratory TSA showed inconclusive results. Overall, the quality of the evidence was very low because of the substantial risk of bias and imprecision. CONCLUSION The limited evidence available shows that GONB with local anaesthetics could reduce headache frequency and intensity compared to placebo, while adding corticosteroids did not show additional benefits. GONB was safe with a similar number of minor adverse events. However, our confidence in these estimates is very low since the evidence is based on a few trials, with a small sample size and a significant risk of bias. In addition, the exploratory TSA was inconclusive, so we need larger and specific trials.
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Affiliation(s)
- Victor Velásquez-Rimachi
- Red de Eficacia Clínica y Sanitaria, Lima, Peru.,Grupo de Investigación en Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru.,Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
| | - Jorge Chachaima-Mar
- Red de Eficacia Clínica y Sanitaria, Lima, Peru.,Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru.,Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Cristian Morán-Mariños
- Red de Eficacia Clínica y Sanitaria, Lima, Peru.,Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru.,Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Peru
| | - Kevin Pacheco-Barrios
- Unidad de Investigación Para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.,Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margarita Posso
- Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carlos Alva-Díaz
- Grupo de Investigación en Neurociencia, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru.,Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru.,Universidad Científica del Sur, Facultad de Ciencias de la Salud, Lima, Peru
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Almosaiteer SA, Rabbani U, Alharbi BA, Aldukhayel A. Quality of life and its predictors among patients with migraine in Qassim region, Saudi Arabia: a cross-sectional study. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Migraine attacks can last for hours to days with severe pain which can affect the daily activities. Literature on quality of life of migraineurs is Saudi Arabia is scarce. This study aimed to assess the quality of life and its predictors among patients with migraine in Qassim region, Saudi Arabia.
Methods
A cross-sectional study was conducted among patients with migraines in Qassim, Saudi Arabia. A self-administered questionnaire was distributed online among migraine patients that included; socio-demographic characteristics and an Arabic version of validated migraine-specific quality of life questionnaire (MSQ), version 2.1. Data analyses were performed in SPSS version 26.
Results
A total of 320 patients with migraines participated in the study. The most common age group was 18–25 years (36.6%) with females were dominant (60.9%). According to the results of MSQ version 2.1, the mean ± SD scores of Role Restrictive (RR), Role Preventive (RP), and Emotion Function (EF) were 67.7 ± 19.7, 68.5 ± 20.6, and 70.6 ± 22.1, respectively. Statistical tests revealed that patients who reported less frequent migraine attacks, had better scores in RR, RP, and EF, while the use of paracetamol and painkillers for the treatment of headache were associated with lower scores in RR, RP, and EF.
Conclusions
The quality of life among patients with migraines was generally moderate. Males demonstrated better QOL than females. Furthermore, patients who had less frequent migraine attacks exhibited better QOL than the others but working patients were likely to demonstrate poor QOL.
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Schim JD, Anderson C, Brunner E, Hirman J, Ogbru A, Cady R, McGill L. Likelihood of response with subsequent dosing for patients with migraine and initial suboptimal response with eptinezumab: A post hoc analysis of two placebo‐controlled randomized clinical trials. Headache 2022; 62:558-565. [PMID: 35524405 PMCID: PMC9321567 DOI: 10.1111/head.14302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/16/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Jack D. Schim
- Headache Center of Southern California Carlsbad California USA
| | | | | | - Joe Hirman
- Pacific Northwest Statistical Consulting Woodinville Washington USA
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Al Ghadeer HA, AlSalman SA, Albaqshi FM, Alsuliman SR, Alsowailem FA, Albusror HA, AlAbdi ZI, Alwabari EM, Alturaifi ZA, AlHajji AM. Quality of Life and Disability Among Migraine Patients: A Single-Center Study in AlAhsa, Saudi Arabia. Cureus 2021; 13:e19210. [PMID: 34873540 PMCID: PMC8638781 DOI: 10.7759/cureus.19210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/05/2022] Open
Abstract
Background Migraine is a major public health issue that leads to frequent visits to medical care. It is generally considered a disabling disease among individuals below the age of 50 years old predominantly seen in females. Migraine headache has a strong influence on disability, functional impairments, and psychological effects. The majority of the physicians fail to address the degree and extent of impediment caused by a migraine, which contributes to low quality of life and disability. Thus, this study aims to assess the health-related quality of life (QOL) and disability among migraine sufferers in AlAhsa, Saudi Arabia. Material and methods This descriptive cross-sectional study was carried out in the neurology clinics at King Fahad Hospital-Hofuf, AlAhsa, Saudi Arabia, from May to August 2021. The data were collected through a self-administered questionnaire. The migraine-specific quality of life questionnaire (MSQ), version 2.1, was used. MSQ is measured in three domains, including role function restrictive (RR), preventive (RP), and emotional function (EF). Disability related to migraine was assessed by the Migraine Disability Assessment Test (MIDAS). MIDAS classifies disability from no disability to severe disability. Two-tailed with an alpha level of 0.05 considering the significance of a p-value less than or equal to 0.05. The mean scores of QOL domains were compared by one-way analysis of variance (ANOVA) and independent t-tests. Results A total of 101 out of 359 participants were identified to have a migraine. Eighty-two participants met the inclusion criteria, 75.6% were females. The age of the participants ranged from 18 to more than 45 years with a mean age of 36.4 ± 11.9 years old. The mean score of QOL in the restrictive, preventive, and emotional domains were 46.3% ± 21.5%, 52.1% ± 24.3%, and 61.5% ± 30.8%, respectively. More than half of the participants (57.3%) suffered from a severe disability caused by migraines as compared to 20.7% with a moderate disability. Low QOL scores were associated with females and a significant relationship was found between migraine-associated disability and patients' emotional function in QOL. Conclusion Clinicians should routinely evaluate disability related to migraine and QOL as a complementary approach to migraine patients to ensure that patients are receiving proper treatment and whether additional strategies are needed or not.
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Cerrada CJ, Min JS, Constantin L, Hitier S, Igracki Turudic I, Amand-Bourdon C, Stewart A, Ebel-Bitoun C, Goadsby PJ. A Prospective Real-World Study Exploring Associations Between Passively Collected Tracker Data and Headache Burden Among Individuals with Tension-Type Headache and Migraine. Pain Ther 2021; 11:153-170. [PMID: 34874543 PMCID: PMC8861247 DOI: 10.1007/s40122-021-00336-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Prevalence and burden of headache disorders in real-world settings is relatively unstudied. We explored the associations between passively collected activity data, headache burden, and quality of life in headache sufferers. Methods Data from wearable activity tracking devices and daily short questionnaires were collected over 12 weeks to assess occurrence of headache, activity, quality of life and self-rated health. Variables were analyzed using a series of mixed-effects models and stratified based on headache type. Multiple linear and logistic regressions were used to analyze treatment preferences.
Results Behaviors inferred from activity tracker data suggested that individuals slept more, had reduced physical activity, and had lower maximum heart rate on days with headache. As headache-specific impact on quality of life increased, activity and maximum heart rate decreased and sleep increased. Headache days with higher self-rated health were associated with less napping, higher step count and maximum heart rate, correlating with increased activity. Migraineurs experienced greater burden in everyday life compared with tension-type headache sufferers.
Conclusion This study adds to existing evidence that activity trackers can be used to quantify headache burden in real-world settings and aid in understanding symptom management. Supplementary Information The online version contains supplementary material available at 10.1007/s40122-021-00336-y.
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Affiliation(s)
| | - Jae S Min
- Evidation Health, San Mateo, CA, USA
| | | | | | | | | | | | | | - Peter J Goadsby
- NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, King's College London, Wellcome Foundation Building, London, SE5 9PJ, UK. .,Department of Neurology, University of California, Los Angeles, CA, USA.
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Siegmund LA, Gornik HL, Fendrikova Mahlay N, Hornacek D, Bena J, Morrison S. The Relationship Among Pain Location, Complications, and Quality of Life in Individuals With Fibromuscular Dysplasia. Pain Manag Nurs 2021; 23:273-280. [PMID: 34348885 DOI: 10.1016/j.pmn.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/04/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fibromuscular dysplasia (FMD), a nonatherosclerotic arterial disease, can cause pain and vascular complications. The aim of this study was to examine the impact of FMD symptoms and complications on quality of life, depression, anxiety, and self-rated health. DESIGN This was a cross-sectional, correlational study. METHODS Participants were adults with a diagnosis of FMD. Quality of life (36-Item Short Form Health Survey), anxiety and depression (Patient-Reported Outcomes Measurement Information System [PROMIS®]), self-rated health question, and symptom/complication questionnaires were mailed to patients with FMD. Scores were compared with symptoms and complications. Multivariable linear models were fit for symptoms and survey scores. Ordinal regression was used for self-rated health. Backwards selection was run for each model. Alpha of 0.05 and 95% confidence intervals were used. RESULTS Of the 162 (275 total; 47.8%) patients who returned surveys (156 female), 130 had carotid or vertebral artery involvement (80.2%). Migraine (p < .001), neck pain (p = .036), and flank pain (p = .025) were associated with decrease in Mental Component scores. Migraine (p = .002) and neck pain (p = .023) were associated with lower Physical Component scores. Patients reporting abdominal pain compared with those without had 4.88 points higher depression. Abdominal pain (p = .031) and pulsatile tinnitus (p = .011) were associated with greater anxiety. Migraine was associated with (p = .002) lower self-rated health. Participants with history of stroke/transient ischemic attack had 2.42 (1.08, 5.46; p = .033) times the odds of poor self-rated health compared with those without stroke/transient ischemic attack. CONCLUSIONS Among patients with FMD, presence of pain and history of vascular complications were related to lower quality of life and self-rated health.
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Affiliation(s)
- Lee Anne Siegmund
- Office of Nursing Research and Innovation, Cleveland Clinic, Cleveland, Ohio.
| | - Heather L Gornik
- Vascular Center, Harrington Heart and Vascular Institute, University Hospitals, Harrington Heart and Vascular Institute
| | | | | | - James Bena
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
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Ashina M, Cohen JM, Gandhi SK, Du E. Reduction in the severity and duration of headache following fremanezumab treatment in patients with episodic and chronic migraine. Headache 2021; 61:916-926. [PMID: 34115380 PMCID: PMC8362007 DOI: 10.1111/head.14127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/10/2021] [Accepted: 03/30/2021] [Indexed: 12/20/2022]
Abstract
Objective To evaluate the impact of fremanezumab on the severity and duration of remaining migraine attacks in patients with chronic migraine (CM) or episodic migraine (EM). Background Fremanezumab is a fully humanized monoclonal antibody (IgGΔa) that selectively targets calcitonin gene‐related peptide and is efficacious in reducing migraine frequency. Methods This exploratory post hoc analysis included data from three randomized, double‐blind, 12‐week, phase 3 studies (HALO CM, HALO EM, and FOCUS). In all three studies, patients with CM or EM were randomized 1:1:1 to receive subcutaneous quarterly fremanezumab (month 1/2/3: 675 mg/placebo/placebo), monthly fremanezumab (month 1/2/3: 675 mg [CM], 225 mg [EM]/225 mg/225 mg), or matched monthly placebo. Changes from baseline were evaluated in the proportion of headache days of at least moderate severity, peak severity of headache days, mean monthly headache hours (of any severity and at least moderate severity), and mean headache hours per headache day of any severity. Results A total of 2843 patients were randomized with 2823 patients included in the efficacy analyses across all studies (HALO CM, N = 1121; HALO EM, N = 865; FOCUS, N = 837). At study baseline, mean (standard deviation [SD]) monthly number of headache days rated moderate or severe in the quarterly fremanezumab, monthly fremanezumab, and placebo groups, respectively, were 13.2 (5.5), 12.8 (5.8), and 13.3 (5.8) in HALO CM; 7.2 (3.1), 6.8 (2.9), and 6.9 (3.1) in HALO EM; and 12.4 (5.8), 12.7 (5.8), and 12.8 (5.9) in FOCUS. Patients experienced significant least‐squares mean (LSM; 95% confidence interval) percent reductions from baseline in monthly number of headache days rated moderate or severe during the 12 weeks: HALO CM, quarterly fremanezumab, 34.5% (−39.8, −29.2) and monthly fremanezumab, 36.2% (−41.4, −31.0) vs. placebo, 19.6% (−20.0, −14.3); HALO EM, quarterly fremanezumab, 40.7% (−47.8, −33.5) and monthly fremanezumab, 43.4% (−50.4, −36.3) vs. placebo, 17.9% (−24.9, −11.0); and FOCUS, quarterly fremanezumab, 36.5% (−41.9, −31.1) and monthly fremanezumab, 38.6% (−44.0, −33.3) vs. placebo, 3.5% (−8.9, 1.8); all p < 0.0001. At study baseline, mean (SD) number of monthly headache hours rated moderate or severe in the quarterly fremanezumab, monthly fremanezumab, and placebo groups, respectively, were 66.4 (58.8), 68.0 (53.9), and 68.5 (57.0) in HALO CM; 33.3 (25.4), 31.7 (23.7), and 31.6 (23.2) in HALO EM; and 59.2 (54.7), 64.3 (65.2), and 65.9 (70.2) in FOCUS. Significant reductions were observed in LSM (standard error) number of monthly headache hours of at least moderate severity: HALO CM, quarterly fremanezumab, 24.4 (2.5) and monthly fremanezumab, 26.4 (2.3) vs. placebo, 14.1 (2.5); HALO EM, quarterly fremanezumab, 14.5 (1.4) and monthly fremanezumab, 15.5 (1.3) vs. placebo, 8.1 (1.3); and FOCUS, quarterly fremanezumab, 16.8 (3.0) and monthly fremanezumab, 18.3 (3.0) vs. placebo, 2.3 (3.0); all p < 0.001. Conclusion These analyses demonstrated that quarterly or monthly treatment with fremanezumab significantly reduced headache severity and duration in patients with CM or EM, including in patients with documented inadequate response to two to four prior migraine preventive medication classes.
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Affiliation(s)
- Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joshua M Cohen
- Global Medical Affairs, Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA
| | - Sanjay K Gandhi
- Global Medical Affairs, Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA
| | - Evelyn Du
- Global Medical Affairs, Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA
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Joyner KR, Morgan KW. Novel Therapies in Acute Migraine Management: Small-Molecule Calcitonin Gene-Receptor Antagonists and Serotonin 1F Receptor Agonist. Ann Pharmacother 2021; 55:745-759. [PMID: 32993366 DOI: 10.1177/1060028020963574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To review the efficacy, safety, and cost of 3 newly approved agents-ubrogepant, lasmiditan, and rimegepant-representing 2 therapeutic classes, calcitonin gene-related peptide (CGRP) receptor antagonist and serotonin 1F (5-HT1F) agonists, for the acute treatment of migraine with or without aura. DATA SOURCES The Institute of Health US National Library of Medicine Clinical Trials, PubMed, and Cochrane databases were queried. Abstracts, journal articles, and other relevant sources published or present were reviewed. Search terms included the following: ubrogepant, MK-1602, Ubrelvy®, rimegepant, Nurtec®, BHV-3000, BMS-927711, lasmiditan, Reyvow®, LY573144. STUDY SELECTION AND DATA EXTRACTION Relevant English-language articles from June 30, 2010, to August 31, 2020, were evaluated and included in the narrative. DATA SYNTHESIS CGRP receptor antagonists, ubrogepant and rimegepant, achieved 2-hour pain freedom and freedom from the most bothersome migraine symptom (MBS) at 2 hours. Both agents were well tolerated, with adverse effects similar to placebo. Lasmiditan, a 5-HT1F receptor antagonist, also improved 2-hour pain freedom and freedom from the MBS at 2 hours. Lasmiditan is associated with dizziness, paresthesia, somnolence, nausea, fatigue, and lethargy. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Ubrogepant, rimegepant, and lasmiditan represent a new and exciting chapter in acute migraine therapy. To date, no head-to-head studies have compared these agents with the triptans. Ubrogepant and lasmiditan are effective in triptan nonresponders. None of the 3 agents is contraindicated in cardiovascular disease, unlike the triptans. CONCLUSIONS Based on available data, ubrogepant, rimegepant, and lasmiditan should be reserved as second-line therapy and may be safe in patients with cardiovascular risk. Lasmiditan's adverse effect profile may limit its use.
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Affiliation(s)
- Kayla Rena Joyner
- Shenandoah University Bernard J. Dunn School of Pharmacy, Winchester, VA, USA
| | - Kelsey Woods Morgan
- Shenandoah University Bernard J. Dunn School of Pharmacy, Winchester, VA, USA
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Narrative Medicine to integrate patients', caregivers' and clinicians' migraine experiences: the DRONE multicentre project. Neurol Sci 2021; 42:5277-5288. [PMID: 33856582 PMCID: PMC8047556 DOI: 10.1007/s10072-021-05227-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/26/2021] [Indexed: 01/03/2023]
Abstract
Background Although migraine is widespread and disabling, stigmatisation and poor awareness of the condition still represent barriers to effective care; furthermore, research on migraine individual and social impact must be enhanced to unveil neglected issues, such as caregiving burden. The project investigated the migraine illness experience through Narrative Medicine (NM) to understand daily life, needs and personal resources of migraneurs, their caregivers and clinicians, and to provide insights for clinical practice. Methods The project involved 13 Italian headache centres and targeted migraneurs, their caregivers and migraine specialists at these centres. Written narratives, composed by a sociodemographic survey and illness plot or parallel chart, were collected through the project’s webpage. Illness plots and parallel charts employed open words to encourage participants’ expression. Narratives were analysed through Nvivo software, interpretive coding and NM classifications. Results One hundred and seven narratives were collected from patients and 26 from caregivers, as well as 45 parallel charts from clinicians. The analysis revealed migraine perception in social, domestic and work life within the care pathway evolution and a bond between chaos narratives and day loss due to migraine; furthermore, narratives suggested the extent of the caregiving burden and a risk of underestimation of migraine burden in patients’ and caregivers’ life. Conclusion The project represents the first investigation on migraine illness experience through NM simultaneously considering migraneurs’, caregivers’ and clinicians’ perspectives. Comparing narratives and parallel charts allowed to obtain suggestions for clinical practice, while NM emerged as able to foster the pursuing of migraine knowledge and awareness. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05227-w.
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14
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Baksh BS, Garcia JC, Galor A. Exploring the Link Between Dry Eye and Migraine: From Eye to Brain. Eye Brain 2021; 13:41-57. [PMID: 33692643 PMCID: PMC7939506 DOI: 10.2147/eb.s234073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/17/2021] [Indexed: 11/23/2022] Open
Abstract
Dry eye and migraine are common diseases with large societal and economic burdens that have recently been associated in the literature. This review outlines the link between dry eye and migraine, which may have implications for reducing their respective burdens. We highlight possible shared pathophysiology, including peripheral and central sensitization, as the potential link between dry eye and migraine. Finally, therapies targeting similar pathophysiological mechanisms between dry eye and migraine are discussed.
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Affiliation(s)
- Brandon S Baksh
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julia Costa Garcia
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Faculdade de Medicina (FMB) da Universidade do Estado de São Paulo (UNESP), Botucatu, Brazil
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL, USA
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15
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Moreno-Ajona D, Pérez-Rodríguez A, Goadsby PJ. Gepants, calcitonin-gene-related peptide receptor antagonists: what could be their role in migraine treatment? Curr Opin Neurol 2021; 33:309-315. [PMID: 32251023 DOI: 10.1097/wco.0000000000000806] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Migraine is the second leading cause of years lived with disability after back pain. Poor tolerability, contraindications, drug-drug interactions and efficacy limited to a subpopulation make new approaches necessary for the acute and preventive treatment of migraine. The study of the calcitonin-gene-related peptide (CGRP) pathway over the last decades is a good example of translational medicine leading to directed therapies for patients. RECENT FINDINGS After some of the first-generation CGRP receptor antagonists, gepants, were not fully developed because of hepatotoxicity, the second generation of gepants have shown efficacy, safety and tolerability in recent clinical trials. SUMMARY Both rimegepant and ubrogepant have published positive randomized placebo-controlled clinical trials data. Vazegepant is the first intranasal gepant for the acute treatment of migraine and has announced a positive phase II/III study. Daily rimegepant use has preliminary data to suggest efficacy. Atogepant has shown efficacy in migraine prevention in a phase II/III study. Most importantly, hepatotoxicity has not been reported in specifically designed phase I studies or long-term extension studies, with rimegepant or ubrogepant, or in a preventive study with atogepant. Given the preventive effect, it seems likely that gepants will not lead to medication overuse headache. They will likely have no cardiovascular warnings. Because of the particular benefit gepants may represent for these groups of patients, specific studies in patients with medication overuse headache, as well as those with comorbid cardiovascular diseases, would be of considerable interest.
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Affiliation(s)
- David Moreno-Ajona
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London.,NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London, UK
| | - Abigail Pérez-Rodríguez
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London.,NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London, UK.,Department of Neurology, Hospital Nuestra Señora Del Rosario, Calle del Príncipe de Vergara, Madrid, Spain
| | - Peter J Goadsby
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London.,NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London, UK
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16
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M H B, R J, A HM. New MRI Finding in Migraineurs: Mesial Temporal Sclerosis. J Biomed Phys Eng 2020; 10:459-466. [PMID: 32802794 PMCID: PMC7416088 DOI: 10.31661/jbpe.v0i0.887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/14/2018] [Indexed: 01/03/2023]
Abstract
Background: Based on our experience, a noticeable number of migraineurs without history of epilepsy disclose mesial temporal sclerosis (MTS) on their brain MRI. Objective: This prospective study was conducted to assess the frequency of MTS in migraineurs and also determine the ratio of unilateral and bilateral cases. Material and Methods: In this cross sectional study, the frequency of MTS in MRI of 84 migraine patients, who had symptoms for at least 2 years,
assessed. Brain MRI was done with T1 and T2 weighted protocols. Two radiologists separately interpreted findings, defining MTS
as presence of any of hippocampal atrophy, increased T2 signal of hippocampus, decreased T1 signal of hippocampus or loss
of internal architecture. Patients who radiologists had not agreement on their diagnoses excluded. Stat analysis done using ‘N - 1’ chi squared test. Results: Eleven patients were excluded due to non-accordant interpretation of MRI findings by the two examining radiologists.
MTS was detected in 14 out of 73 patients (19%). Bilateral involvement of mesial temporal lobe was seen in 6 (8%) patients
(M 67%, F 33%). Five cases (7%) had unilateral left MTS (M 67%, F 33%) while 3 (4%) were affected with right-sided MTS (M 33%, F 67%).
These findings highly suggest association of MTS and Migraine (P-value <0.0001). Conclusion: While MTS is a prevalent finding in migraineurs, incidental finding of MTS in MRI should suspect physicians of migraine as well as temporal lobe epilepsy. MTS can be proposed as an etiology of migraine but most likely, consequence of it.
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Affiliation(s)
- Bagheri M H
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- MD, Department of Radiology and Imaging Sciences (A.P., R.S., D.S.R., M.B., T.E.C., D.A.B.), National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Jalli R
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hoseyni Moghadam A
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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van Casteren DS, van Willigenburg FAC, MaassenVanDenBrink A, Terwindt GM. Jealousy in women with migraine: a cross-sectional case-control study. J Headache Pain 2020; 21:51. [PMID: 32393167 PMCID: PMC7216716 DOI: 10.1186/s10194-020-01114-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Estrogen influences susceptibility to migraine attacks and it has been suggested to affect jealousy in romantic relationships in women. Therefore, we hypothesized that migraine women may be more jealous. METHODS Jealousy levels and hormonal status were determined based on a cross-sectional, web-based, questionnaire study among female migraine patients and controls. A random sample of participants was selected from a validated migraine database. Participants with a serious and intimate monogamous relationship were included (n = 498) and divided into the following subgroups: menstrual migraine (n = 167), non-menstrual migraine (n = 103), postmenopausal migraine (n = 117), and premenopausal (n = 57) and postmenopausal (n = 54) controls. The primary outcome was the difference in mean jealousy levels between patients with menstrual migraine, non-menstrual migraine and premenopausal controls. Results were analyzed with a generalized linear model adjusting for age, relationship duration and hormonal status (including oral contraceptive use). Additionally, the difference in jealousy levels between postmenopausal migraine patients and controls was assessed. Previous research was replicated by evaluating the effect of combined oral contraceptives on jealousy. RESULTS Jealousy levels were higher in menstrual migraine patients compared to controls (mean difference ± SE: 3.87 ± 1.09, p = 0.001), and non-menstrual migraine patients compared to controls (4.98 ± 1.18, p < 0.001). No difference in jealousy was found between postmenopausal migraine patients and controls (- 0.32 ± 1.24, p = 0.798). Women using combined oral contraceptives were more jealous compared to non-users with a regular menstrual cycle (2.32 ± 1.03, p = 0.025). CONCLUSION Young women with migraine are more jealous within a romantic partnership.
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Affiliation(s)
- Daphne S van Casteren
- Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | | | - Antoinette MaassenVanDenBrink
- Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
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Dodick DW, Lipton RB, Ailani J, Halker Singh RB, Shewale AR, Zhao S, Trugman JM, Yu SY, Viswanathan HN. Ubrogepant, an Acute Treatment for Migraine, Improved Patient-Reported Functional Disability and Satisfaction in 2 Single-Attack Phase 3 Randomized Trials, ACHIEVE I and II. Headache 2020; 60:686-700. [PMID: 32073660 PMCID: PMC7155006 DOI: 10.1111/head.13766] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of ubrogepant on patient-reported functional disability, satisfaction with study medication, and global impression of change. BACKGROUND Ubrogepant is a small-molecule, oral calcitonin gene-related peptide receptor antagonist indicated for the acute treatment of migraine. In 2 phase 3 trials (ACHIEVE I and II), ubrogepant demonstrated efficacy vs placebo on the 2 co-primary endpoints of headache pain freedom and absence of the most bothersome migraine-associated symptom at 2 hours post dose for the 50 and 100 mg doses. Patient-reported outcomes, such as functional disability, satisfaction, and patient global impression of change, can provide additional evidence of the efficacy of an acute treatment for migraine on clinically meaningful and patient-relevant outcomes. METHODS ACHIEVE I and ACHIEVE II were multicenter, randomized, double-blind, placebo-controlled, parallel-group, single-attack trials in adults (18-75 years) with migraine. In ACHIEVE I, participants were randomized 1:1:1 to placebo or ubrogepant 50 or 100 mg; in ACHIEVE II, participants were randomized 1:1:1 to placebo or ubrogepant 25 or 50 mg to treat a migraine attack with moderate or severe headache pain. Participants rated ability to perform daily activities on the Functional Disability Scale, before dosing and at 1, 2, 4, and 8 hours after the initial dose; satisfaction with study medication at 2 and 24 hours; and impression of overall change in migraine on the Patient Global Impression of Change scale at 2 hours. In prespecified analyses for each trial, each outcome was compared between each ubrogepant dose group and the relevant placebo group. Data were pooled from the ubrogepant 50 mg and placebo groups of the 2 trials in a post hoc analysis. RESULTS In ACHIEVE I, 559 participants were randomized to placebo, 556 to ubrogepant 50 mg, and 557 to ubrogepant 100 mg; in ACHIEVE II, 563 were randomized to placebo, 561 to ubrogepant 25 mg, and 562 to ubrogepant 50 mg. At 2 hours post dose, significantly higher proportions of ubrogepant-treated participants vs placebo-treated participants reported being able to function normally (ACHIEVE I: ubrogepant 50 mg, 40.6% [171/421], P = .0012 vs placebo; ubrogepant 100 mg, 42.9% [192/448], P < .0001 vs placebo; placebo, 29.8% [136/456]; ACHIEVE II: ubrogepant 25 mg, 42.6% [185/434], P = .0015 vs placebo; ubrogepant 50 mg, 40.5% [188/464], P = .0118 vs placebo; placebo, 34.2% [156/456]; pooled 50 mg, 40.6% [359/885], vs pooled placebo, 32.0% [292/912]; P < .0001), were satisfied/extremely satisfied with study medication (ACHIEVE I: 50 mg, 36.3% [147/405], P < .0001 vs placebo; 100 mg, 35.8% [149/416], P = .0002 vs placebo; placebo, 24.1% [104/432]; ACHIEVE II: 25 mg, 35.1% [141/402], P = .0018 vs placebo; 50 mg, 37.8% [163/431], P < .0001 vs placebo; placebo, 24.8% [106/427]; pooled ubrogepant 50 mg, 37.1% [310/836], vs pooled placebo, 24.5% [210/859]; P < .0001), and indicated that their migraine was much/very much better on the Patient Global Impression of Change scale (ACHIEVE I: 50 mg, 34.4% [103/299], P = .0006 vs placebo; 100 mg, 34.3% [102/297], P = .0009 vs placebo; placebo, 22.0% [69/313]; ACHIEVE II: 25 mg, 34.1% [124/364], P < .0001 vs placebo; 50 mg, 33.4% [131/392], P = .0002 vs placebo; placebo, 20.7% [78/376]; pooled 50 mg, 33.9% [234/691], vs pooled placebo, 21.3% [147/689]; P < .0001). CONCLUSIONS A significantly higher proportion of participants treated with ubrogepant were able to function normally, were satisfied with the study medication, and reported clinically meaningful improvement compared with those receiving placebo. The results reinforce the potential benefits of ubrogepant on patient-centered outcomes in the acute treatment of migraine.
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Affiliation(s)
| | | | - Jessica Ailani
- MedStar Georgetown University Hospital, Washington, DC, USA
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Job Satisfaction Mediates the Association between Perceived Disability and Work Productivity in Migraine Headache Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183341. [PMID: 31510071 PMCID: PMC6765904 DOI: 10.3390/ijerph16183341] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/17/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
Abstract
Migraine headache is the cause of an estimated 250,000,000 lost days from work or school every year and is often associated with decreased work productivity. The aim of this cross-sectional study was to assess the relationship between perceived disability, job satisfaction and work productivity in patients affected by chronic migraineurs. Participants were 98 consecutive adult outpatients admitted to the Regional Referral Headache Centre of the Sant’Andrea Hospital in Rome, Italy. Patients were administered the Italian Perceived Disability Scale, The Quality of Life Enjoyment and Satisfaction Questionnaire–Work Subscale and The Endicott Work Productivity Scale. Perceived disability is significantly associated with job satisfaction and work productivity. Job satisfaction is significantly related to work productivity and mediates the association between perceived disability and work productivity in patients affected by chronic migraineurs. Our results confirm that patients suffering from migraine headaches who have negative perceptions of their disability are less satisfied with their job, which in turn, decreases their work productivity.
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Moreno‐Ajona D, Chan C, Villar‐Martínez MD, Goadsby PJ. Targeting CGRP and 5‐HT
1F
Receptors for the Acute Therapy of Migraine: A Literature Review. Headache 2019; 59 Suppl 2:3-19. [DOI: 10.1111/head.13582] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2019] [Indexed: 12/21/2022]
Affiliation(s)
- David Moreno‐Ajona
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience King’s College London London UK
- NIHR‐Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre King’s College Hospital London UK
| | - Calvin Chan
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience King’s College London London UK
- NIHR‐Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre King’s College Hospital London UK
| | - María Dolores Villar‐Martínez
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience King’s College London London UK
- NIHR‐Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre King’s College Hospital London UK
| | - Peter J. Goadsby
- Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience King’s College London London UK
- NIHR‐Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre King’s College Hospital London UK
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Leonardi M, Raggi A. A narrative review on the burden of migraine: when the burden is the impact on people's life. J Headache Pain 2019; 20:41. [PMID: 31023226 PMCID: PMC6734273 DOI: 10.1186/s10194-019-0993-0] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/08/2019] [Indexed: 12/14/2022] Open
Abstract
Background The burden of headache disorders, and of migraine in particular, is multifaceted and fragmented. The aim of this narrative review is to provide a description the main topics underlying the concepts of burden and impact of migraine disorders. Main results MedLine has been searched for publications covering the period 1990–2018 dealing with the terms burden or impact of migraine, including both episodic and chronic migraine. The main results and themes are reported in a descriptive way, and were grouped by similarity of content into overarching categories. A total of 49 papers, published over 25 years (1994–2018), were retained for the qualitative analysis. Six main themes were identified: prevalence of migraine disorders, overall impact of migraine disorders, impact on work or school activities, family impact, interictal burden, and disease costs. Majority of included studies concluded that patients with migraine reported an higher burden or impact in one or more of the six main themes herein identified, compared to non-headache patients or to patients with tension-type headache, with a tendency towards worse outcomes consistently with higher headache frequency. Conclusions The results of this narrative review show that the meaning of a sentence like “migraine is a burdensome condition” is not univocal: rather, it may refer to different concepts and meanings. In our opinion, future research should focus on understanding and facing the impact of migraine on work-related activities and on everyday life activities, as these aspects are highly connected to some tangible (i.e. cost) and less tangible (i.e. interictal burden and reduced quality of life) facets of migraine burden. Disease-specific measures have been implemented and should be exploited to enhance our understanding of migraine burden. This approach would allow to better understand the real impact on people’s life of such a burdensome disease.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
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Sajobi TT, Amoozegar F, Wang M, Wiebe N, Fiest KM, Patten SB, Jette N. Global assessment of migraine severity measure: preliminary evidence of construct validity. BMC Neurol 2019; 19:53. [PMID: 30947702 PMCID: PMC6448190 DOI: 10.1186/s12883-019-1284-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 03/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background In persons with migraine, severity of migraine is an important determinant of several health outcomes (e.g., patient quality of life and health care resource utilization). This study investigated how migraine patients rate the severity of their disease and how these ratings correlate with their socio-demographic, clinical, and psycho-social characteristics. Methods This is a cohort of 263 adult migraine patients consecutively enrolled in the Neurological Disease and Depression Study (NEEDs). We obtained a broad range of clinical and patient-reported measures (e.g., patients’ ratings of migraine severity using the Global Assessment of Migraine Severity (GAMS), and migraine-related disability, as measured by the Migraine Disability Scale (MIDAS)). Depression was measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 14-item Hospital Anxiety and Depression Scale (HADS). Median regression analysis was used to examine the predictors of patient ratings of migraine severity. Results The mean age for the patients was 42.5 years (SD = 13.2). While 209 (79.4%) patients were females, 177 (67.4%) participants reported “moderately severe” to “extremely severe” migraine on the GAMS, and 100 (31.6%) patients had chronic migraine. Patients’ report of severity on the GAMS was strongly correlated with patients’ ratings of MIDAS global severity question, overall MIDAS score, migraine type, PHQ-9 score, and frequency of migraine attacks. Mediation analyses revealed that MIDAS mediated the effect of depression on patient ratings of migraine severity, accounting for about 32% of the total effect of depression. Overall, migraine subtype, frequency of migraine, employment status, depression, and migraine-related disability were statistically significant predictors of patient-ratings of migraine severity. Conclusions This study highlights the impact of clinical and psychosocial determinants of patient-ratings of migraine severity. GAMS is a brief and valid tool that can be used to assess migraine severity in busy clinical settings.
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Affiliation(s)
- Tolulope T Sajobi
- Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine 3280 Hospital Drive NW Calgary, Calgary, Alberta, T2N 4Z6, Canada.
| | - Farnaz Amoozegar
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Meng Wang
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Natalie Wiebe
- Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine 3280 Hospital Drive NW Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Kirsten M Fiest
- Department of Critical Medicine, University of Calgary, Calgary, Canada
| | - Scott B Patten
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Nathalie Jette
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
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Jackson JL, Kuriyama A, Kuwatsuka Y, Nickoloff S, Storch D, Jackson W, Zhang ZJ, Hayashino Y. Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis. PLoS One 2019; 14:e0212785. [PMID: 30893319 PMCID: PMC6426199 DOI: 10.1371/journal.pone.0212785] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/10/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Headaches are a common source of pain and suffering. The study's purpose was to assess beta-blockers efficacy in preventing migraine and tension-type headache. METHODS Cochrane Register of Controlled Trials; MEDLINE; EMBASE; ISI Web of Science, clinical trial registries, CNKI, Wanfang and CQVIP were searched through 21 August 2018, for randomized trials in which at least one comparison was a beta-blocker for the prevention of migraine or tension-type headache in adults. The primary outcome, headache frequency per month, was extracted in duplicate and pooled using random effects models. DATA SYNTHESIS This study included 108 randomized controlled trials, 50 placebo-controlled and 58 comparative effectiveness trials. Compared to placebo, propranolol reduced episodic migraine headaches by 1.5 headaches/month at 8 weeks (95% CI: -2.3 to -0.65) and was more likely to reduce headaches by 50% (RR: 1.4, 95% CI: 1.1-1.7). Trial Sequential Analysis (TSA) found that these outcomes were unlikely to be due to a Type I error. A network analysis suggested that beta-blocker's benefit for episodic migraines may be a class effect. Trials comparing beta-blockers to other interventions were largely single, underpowered trials. Propranolol was comparable to other medications known to be effective including flunarizine, topiramate and valproate. For chronic migraine, propranolol was more likely to reduce headaches by at least 50% (RR: 2.0, 95% CI: 1.0-4.3). There was only one trial of beta-blockers for tension-type headache. CONCLUSIONS There is high quality evidence that propranolol is better than placebo for episodic migraine headache. Other comparisons were underpowered, rated as low-quality based on only including single trials, making definitive conclusions about comparative effectiveness impossible. There were few trials examining beta-blocker effectiveness for chronic migraine or tension-type headache though there was limited evidence of benefit. REGISTRATION Prospero (ID: CRD42017050335).
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Affiliation(s)
- Jeffrey L. Jackson
- Department of Medicine, Zablocki VA Medical Center, Milwaukee, WI, United States of America
| | - Akira Kuriyama
- Department of General Medicine, Kurashiki Central Hospital, Okayama, Japan
| | | | - Sarah Nickoloff
- Department of Medicine, Zablocki VA Medical Center, Milwaukee, WI, United States of America
| | - Derek Storch
- Department of Medicine, Zablocki VA Medical Center, Milwaukee, WI, United States of America
| | - Wilkins Jackson
- Department of Biology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Zhi-Jiang Zhang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
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Is Medication Overuse Drug Specific or Not? Data from a Review of Published Literature and from an Original Study on Italian MOH Patients. Curr Pain Headache Rep 2018; 22:71. [DOI: 10.1007/s11916-018-0729-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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25
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Grinberg AS, Seng EK. Headache-Specific Locus of Control and Migraine-Related Quality of Life: Understanding the Role of Anxiety. Int J Behav Med 2017; 24:136-143. [PMID: 27488417 DOI: 10.1007/s12529-016-9587-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE This cross-sectional study examined the relationship between headache-specific locus of control (HSLC) and migraine-related quality of life, and anxiety as a mediator of this relationship. METHOD Two hundred and thirty-two people with migraine participated in the treatment of severe migraine trial. At baseline, participants completed self-report questionnaires of headache-specific locus of control (HSLC; subscales = internal, chance, and medical professionals), anxiety, and migraine-related quality of life. Correlations examined relationships between HSLC, anxiety, and migraine-related quality of life; ordinary least squares regression evaluated anxiety as a mediator of the relationship between HSLC and migraine-related quality of life. RESULTS Higher internal HSLC was related to higher overall migraine-related quality of life (ps < .05) and emotion function impairments (p = .012). Anxiety mediated the relationship between internal HSLC and all measures of migraine-specific quality of life (ps < .05). Higher external (medical professionals and chance) HSLC was related to higher migraine-related quality of life impairments (all ps < .001). CONCLUSION All HSLC beliefs are associated with higher migraine-related quality of life impairments. Anxiety mediates the relationship between internal HSLC and migraine-related quality of life.
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Affiliation(s)
- Amy S Grinberg
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY, USA.
| | - Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Bronx, NY, USA.,Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Bronx, NY, USA
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26
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Orr SL, Christie SN, Akiki S, McMillan HJ. Disability, Quality of Life, and Pain Coping in Pediatric Migraine: An Observational Study. J Child Neurol 2017; 32:717-724. [PMID: 28393667 DOI: 10.1177/0883073817702025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The objective was to examine the relationship between disability, health-related quality of life (HrQoL), and pain coping in pediatric migraineurs. METHOD Eighty-five patients with migraine were recruited from Pediatric Neurology clinics. Participants completed the Pediatric Migraine Disability Assessment Scale, the Pediatric Quality of Life Inventory, the Pain Coping Questionnaire, and the Pain Catastrophizing Scale. Means were compared to published norms using t-tests. Spearman correlations and logistic regression were used to explore the relationships between the variables. RESULTS Mean HrQoL scores were lower than norms for controls and chronically ill pediatric patients ( P < .0001). Patients reported lower mean pain coping scores and higher mean pain catastrophizing scores than norms ( P < .0001). After controlling for age and sex, only the relationship between disability and HrQoL remained significant (OR = 0.91, 95% CI: 0.86-0.95). CONCLUSION Pediatric patients with migraine report lower HrQoL, fewer pain coping strategies and more catastrophizing than controls, while disability is inversely associated with HrQoL.
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Affiliation(s)
- Serena L Orr
- 1 University of Ottawa, Ottawa, Ontario, Canada.,2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Salwa Akiki
- 2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Hugh J McMillan
- 1 University of Ottawa, Ottawa, Ontario, Canada.,2 Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Myofascial Trigger Points and Migraine-related Disability in Women With Episodic and Chronic Migraine. Clin J Pain 2017; 33:109-115. [DOI: 10.1097/ajp.0000000000000387] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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Psychosocial difficulties in patients with episodic migraine: a cross-sectional study. Neurol Sci 2016; 37:1979-1986. [PMID: 27613711 DOI: 10.1007/s10072-016-2705-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
Abstract
To explore the relationships between psychosocial difficulties (PSDs), quality of life (QoL), and disability and to explore the degree to which PSDs can be predicted by demographic variables, clinical variables, and risk and protective factors. Patients with episodic migraine completed a protocol inclusive of PARADISE 24 questionnaire (the 24-item Psychosocial Difficulties Relevant to Brain Disorders questionnaire), a new questionnaire that captures PSDs relevant to brain disorders, and assessments of disability, QoL, disease severity, presence of comorbidities, social support, and clinical and risk factors (i.e., smoking and body mass index). Spearman's correlation was used to address the relationship between PARADISE 24, and the assessments of disability and QoL; multivariable linear regression analysis was carried out to address PARADISE 24 predictors. Eighty patients were enrolled (86.3 % females, mean age 44.5). PARADISE 24 was well correlated with disability (ρ = 0.787) and moderately with QoL (ρ = -0.526). The regression analysis shows that younger age, higher migraine frequency, higher comorbidities index and being a smoker were predictors of PARADISE 24 (R 2: 0.470). Addressing the burden associated with PSDs in migraineurs is important as these might be the reason why patients look for specialists in headache disorders. PARADISE 24 represents a viable way to address patients' difficulties in daily practice.
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Triptans Use for Migraine Headache among Nonelderly Adults with Cardiovascular Risk. PAIN RESEARCH AND TREATMENT 2016; 2016:8538101. [PMID: 27630773 PMCID: PMC5005539 DOI: 10.1155/2016/8538101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 07/15/2016] [Accepted: 08/01/2016] [Indexed: 12/20/2022]
Abstract
Objective. To examine the association between the cardiovascular (CV) risk factors and triptans use among adults with migraine. Methods. A retrospective cross-sectional study design was used. Data were derived from 2009–2013 Medical Expenditure Panel Survey (MEPS). The study sample consisted of adults (age > 21 years) with migraine headache (N = 1,652). Multivariable logistic regression was used to examine the relationship between CV risk factors and triptans use. Results. Overall, 21% adults with migraine headache used triptans. Nearly two-thirds (61%) of adults with migraine had at least one CV risk factor. A significantly lower percentage of adults with CV risk (18.1%) used triptans compared to those without CV risk factors (25.5%). After controlling for demographic, socioeconomic status, access to care, and health status, adults with no CV risk factors were more likely to use triptans as compared to those with one CV risk factor (AOR = 1.83, 95% CI = 1.17–2.87). There were no statistically significant differences in triptans use between those with two or more CV risk factors and those with one CV risk factor. Conclusion. An overwhelming majority of adults with migraine had a contraindication to triptans based on their CV risk factors. The use of triptans among adults with migraine and multiple CV risk factors warrants further investigation.
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Ciere Y, Visser A, Lebbink J, Sanderman R, Fleer J. Impaired Mood in Headache Clinic Patients: Associations With the Perceived Hindrance and Attainability of Personal Goals. Headache 2016; 56:1022-32. [PMID: 27197699 DOI: 10.1111/head.12843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/25/2016] [Accepted: 03/03/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Headache disorders are often accompanied by impaired mood, especially in the headache clinic population. There is a large body of literature demonstrating that an illness or disability may affect the way in which patients perceive their personal goals and that the perception that the attainability of goals is hindered by the illness is a risk factor for impaired mood. However, empirical evidence regarding the extent to which goals are hindered or less attainable as a result of a headache disorder, and how that is related to mood, is currently lacking. OBJECTIVE The aim of this cross-sectional study was to examine associations between headache severity, goal hindrance and attainability, and mood in a headache clinic population. METHODS The sample consisted of 65 adult patients seeking treatment at a tertiary headache clinic. Prior to their first appointment in the clinic, patients completed self-report measures of headache severity, goals and mood (PANAS). RESULTS Higher self-reported headache intensity was associated with higher goal hindrance (r = .38, P = .004), whereas greater headache frequency was associated with lower goal attainability (r = .30, P = .022). Higher perceived goal hindrance was associated with lower positive mood (r = -.27, P = .032) and higher negative mood (r = .28, P = .027). Furthermore, lower perceived goal attainability was associated with higher negative mood (r = -.34, P = .007). Goal perceptions explained an additional 11.4% of the variance in positive mood (F = 3.250, P = .047 <.05) and 10.5% of the variance in negative mood (F = 3.459, P = .039) beyond the effect of age and headache severity. CONCLUSION The results of this preliminary study suggest that perceptions of increased goal hindrance and decreased goal attainability may indeed be a risk factor for impaired mood in the headache clinic population and highlight the need for further, longitudinal research. Obtaining more insight into goal processes (eg, what types of goals are specifically disturbed, which goal adjustment strategies are (mal)adaptive) may help to identify ways to improve outcomes in the headache clinic population.
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Affiliation(s)
- Yvette Ciere
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
| | - John Lebbink
- Department of Neurology, AZ Zeno Hospital, Knokke Heist, Belgium
| | - Robbert Sanderman
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Joke Fleer
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
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Gustafson SL. Bowenwork for Migraine Relief: a Case Report. Int J Ther Massage Bodywork 2016; 9:19-28. [PMID: 26977217 PMCID: PMC4771487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Migraine is a complex neurological disorder characterized by episodic, neurogenic, cerebrovascular inflammation and hypersensitization of brain tissues and the central nervous system, causing severe pain and debility. Research literature points mostly to pharmaceutical prophylactic and symptomatic treatments, nonpharmaceutical, complementary and alternative medicine (CAM) approaches, acupuncture, massage and bodywork studies, and none has been published on Bowenwork for migraine intervention. This prospective case report describes one migraineur's response to Bowenwork (a soft-tissue bodywork technique) with cessation of migraine, neck pain, and analgesic consumption, and improved well-being and activity function. METHODS The client received 14 Bowenwork sessions over a four-month period using the self-reporting Measure Yourself Medical Outcome Profile version 2 (MYMOP2) to evaluate clinically meaningful changes. Baseline MYMOP2 data were recorded prior to the first and subsequent Bowenwork sessions to track changes in migraine and neck pain occurrences, other symptoms, medication use, functional ability and sense of well-being. Specific Bowenwork procedures were applied in each session to address various symptoms. The client did not receive other migraine treatment during this study. PARTICIPANT A 66-year-old Caucasian female with a history of debilitating migraine since childhood, and severe neck pain and jaw injuries resulting from two motor vehicle accidents (MVAs) sustained as an adult. She had previously sought medical, pharmaceutical and CAM treatments for migraine, neck pain, and right-sided thoracic outlet syndrome (TOS) symptoms, with no satisfactory relief. RESULTS The client progressively reported decreased migraine and neck pain until acquiring a respiratory infection with prolonged coughing spells causing symptoms to recur (session 11). Prior to session 12, she experienced an allergic reaction to ingesting an unknown food allergen, requiring three days of prednisone and Benadryl treatment, exacerbating neck pain, but not migraine. At session 14, her MYMOP2 data showed no migraine, neck pain or medication use, improved activity function, and sense of well-being. Symptoms in her right arm and thumb persisted to a lesser extent. CONCLUSION Bowenwork progressively offered migraine and neck pain relief for one chronic migraineur, with multiple somatic symptoms. Extenuating factors (jaw tension, TOS, respiratory infection, and allergic reaction) added complexity in monitoring progress and selecting appropriate Bowenwork procedures. Further research on Bowenwork's efficacy for migraine treatment on larger populations is needed.
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Abstract
Several international campaigns to increase awareness on the high burden of migraine stimulated population-based studies in the last few years that provided broader data on prevalence, correlates, and impact of migraine. The last version of the Global Burden of Disease 2010 posed migraine with a twofold increase with respect to the previous version as one of the first disabling diseases. Migraine, and in general headache disorders are among the top ten causes of disability because they are common and disabling: that is now clear. It is also clear that the descriptive epidemiology of migraine has reached its maturity. The prevalence rates and sociodemographic correlates have been stable across 50 years. Last but not least, despite international efforts an illness that can be relieved does not, and the heavy burden that it poses at individual and societal levels, persists when it could be mitigated. Describing and accounting the burden of migraine worldwide is not enough anymore, we need to change our paradigm again and move towards new pathways. The opportunity is provided by the biopsychosocial approach that enables to act on the environment once the most adequate medical therapy has been provided. To reduce the burden, international efforts should focus certainly on development of new drugs but mainly on improving health care systems' response to millions of migraine and headache sufferers.
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D'Amico D, Leonardi M, Grazzi L, Curone M, Raggi A. Disability and quality of life in patients with different forms of migraine. J Headache Pain 2015; 16:A4. [PMID: 28132384 PMCID: PMC4715119 DOI: 10.1186/1129-2377-16-s1-a4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Domenico D'Amico
- Headache and Neuroalgology Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy.
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
| | - Licia Grazzi
- Headache and Neuroalgology Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
| | - Marcella Curone
- Headache and Neuroalgology Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
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Abstract
Migraine is a disease that contributes to major disability. Perhaps because migraine attacks are not immediately life-threatening per se and individuals return to a "normal" state between attacks, it is not taken seriously. However, migraine is associated with a number of comorbidities, including psychiatric disease, stroke, and other chronic pain disorders. Current acute treatments for episodic migraine are relatively effective, but preventive treatments for episodic and chronic migraine are far less so. Recent functional imaging studies have shown that the disease affects brain function and structure (either as a result of its genetic predisposition or as a result of repeated attacks). The current evidence in the pain field is that changes observed in brain function and structure may be reversible, adding credence to the notion that treating the disease aggressively and early may be beneficial to patients. Here we suggest a change in our approach to a disease that is currently not treated with the urgency that it deserves given its global prevalence, disease burden, and effects on brain function.
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Affiliation(s)
- David Borsook
- Center for Pain and the Brain (DB), Boston Children's and Massachusetts General Hospitals, Harvard Medical School; Department of Anesthesia, Critical Care and Pain Medicine (DB), Boston Children's Hospital; and Department of Neurology (DWD), Mayo Clinic, Phoenix, AZ
| | - David W Dodick
- Center for Pain and the Brain (DB), Boston Children's and Massachusetts General Hospitals, Harvard Medical School; Department of Anesthesia, Critical Care and Pain Medicine (DB), Boston Children's Hospital; and Department of Neurology (DWD), Mayo Clinic, Phoenix, AZ
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Jackson JL, Cogbill E, Santana-Davila R, Eldredge C, Collier W, Gradall A, Sehgal N, Kuester J. A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache. PLoS One 2015; 10:e0130733. [PMID: 26172390 PMCID: PMC4501738 DOI: 10.1371/journal.pone.0130733] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 05/24/2015] [Indexed: 01/03/2023] Open
Abstract
Objective To compare the effectiveness and side effects of migraine prophylactic medications. Design We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models. Data Sources PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014. Eligibility Criteria for Selecting Studies We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration. Results Placebo controlled trials included alpha blockers (n = 9), angiotensin converting enzyme inhibitors (n = 3), angiotensin receptor blockers (n = 3), anticonvulsants (n = 32), beta-blockers (n = 39), calcium channel blockers (n = 12), flunarizine (n = 7), serotonin reuptake inhibitors (n = 6), serotonin norepinephrine reuptake inhibitors (n = 1) serotonin agonists (n = 9) and tricyclic antidepressants (n = 11). In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82), -flunarizine (-1.1 headaches/month (ha/month), 95% CI: -1.6 to -0.67), fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17), metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46), pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21), propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62), topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73) and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8). Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril), two angiotensin receptor blockers (candesartan, telmisartan), two anticonvulsants (lamotrigine, levetiracetam), and several beta-blockers (atenolol, bisoprolol, timolol). Network meta-analysis found amitriptyline to be better than several other medications including candesartan, fluoxetine, propranolol, topiramate and valproate and no different than atenolol, flunarizine, clomipramine or metoprolol. Conclusion Several drugs good evidence supporting efficacy. There is weak evidence supporting amitriptyline’s superiority over some drugs. Selection of prophylactic medication should be tailored according to patient preferences, characteristics and side effect profiles.
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Affiliation(s)
- Jeffrey L. Jackson
- General Internal Medicine, Zablocki VA Medical Center, Milwaukee, Wisconsin, United States of America
- * E-mail:
| | - Elizabeth Cogbill
- Department of Medicine, Western Michigan School of Medicine, Kalamazoo, Michigan, United States of America
| | - Rafael Santana-Davila
- Division of Hematology and Oncology, University of Washington, Seattle, Washington, United States of America
| | - Christina Eldredge
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - William Collier
- Department of Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Andrew Gradall
- School of Health Sciences, Gollis University, Hergaisa, Somaliland
| | - Neha Sehgal
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Jessica Kuester
- General Internal Medicine, Zablocki VA Medical Center, Milwaukee, Wisconsin, United States of America
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Difficulties in work activities and the pervasive effect over disability in patients with episodic and chronic migraine. Neurol Sci 2015; 36 Suppl 1:9-11. [DOI: 10.1007/s10072-015-2130-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abu Bakar N, Tanprawate S, Lambru G, Torkamani M, Jahanshahi M, Matharu M. Quality of life in primary headache disorders: A review. Cephalalgia 2015; 36:67-91. [PMID: 25888584 DOI: 10.1177/0333102415580099] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 03/03/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is emerging as an important element of clinical research in primary headache disorders, allowing a measure of the impact of headache on patients' well-being and daily life. A better understanding of this may contribute to improved resource allocations and treatment approaches. OBJECTIVE The objective of this study is to review available data on HRQoL in primary headache disorders and identify any influencing factors. METHODS Database searches including MEDLINE, PsycINFO and EMBASE were performed. Studies that investigated HRQoL in patients with primary headache disorders were included and reviewed. Trials that evaluated the efficacy of medications or interventions were excluded. RESULTS A total of 80 articles were included in the review. Both physical and emotional/mental aspects of HRQoL were impaired across headache subtypes, although the extent varied depending on headache type. A number of factors influencing HRQoL were also identified. CONCLUSION This narrative review suggests that headache, particularly in its chronic form, has a great impact on HRQoL. Clinical practice should not solely focus on pain alleviation but rather adopt routine assessment of HRQoL. Furthermore, identification and management of associated psychological comorbidities, which can significantly influence HRQoL in headache sufferers, are essential for optimal clinical management.
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Affiliation(s)
- Norazah Abu Bakar
- Headache Group, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Surat Tanprawate
- Headache Group, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Giorgio Lambru
- Headache Group, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Mariam Torkamani
- Sobell Department of Motor Neuroscience & Movement Disorders, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Marjan Jahanshahi
- Sobell Department of Motor Neuroscience & Movement Disorders, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Manjit Matharu
- Headache Group, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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Krymchantowski AV, Jevoux CDC. The Pharmacological Treatment of Migraine in Brazil. Headache 2015; 55 Suppl 1:51-8. [DOI: 10.1111/head.12513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2014] [Indexed: 11/29/2022]
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Shaik MM, Hassan NB, Tan HL, Gan SH. Quality of life and migraine disability among female migraine patients in a tertiary hospital in Malaysia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:523717. [PMID: 25632394 PMCID: PMC4302372 DOI: 10.1155/2015/523717] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 12/18/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls. METHODS Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire. RESULTS Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9, P<0.001). Similarly, physical health (23.4 versus 27.7, P<0.001) and psychological health scores (21.7 versus 23.2, P< 0.001) were significantly lower than those for healthy controls. Seventy-three percent of patients experienced severe disability, with significantly higher number of days with headaches (13.8 days/3 months, P< 0.001) and pain scores (7.4, P< 0.013). Furthermore, migraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores. CONCLUSIONS The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients.
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Affiliation(s)
- Munvar Miya Shaik
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Norul Badriah Hassan
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Huay Lin Tan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Siew Hua Gan
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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Chronic migraine with medication overuse: Association between disability and quality of life measures, and impact of disease on patients' lives. J Neurol Sci 2015; 348:60-6. [DOI: 10.1016/j.jns.2014.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/31/2014] [Accepted: 11/03/2014] [Indexed: 01/20/2023]
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The role of headache chronicity among predictors contributing to quality of life in patients with migraine: a hospital-based study. J Headache Pain 2014; 15:68. [PMID: 25278151 PMCID: PMC4194437 DOI: 10.1186/1129-2377-15-68] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Headache chronicity has been known to elicit deleterious effects on quality of life (QOL). We evaluated the contribution of headache chronicity to QOL in relation to clinical, psychiatric, and psychosocial variables in patients with migraine. METHODS Subjects were recruited from a headache clinic and completed self-report questionnaires including the Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Migraine-Specific Quality of Life (MSQoL). We obtained predictors of MSQoL by multiple regression analyses. A path analysis model was constructed to analyze interrelationships between the variables. RESULTS Among 251 eligible patients, 183 (72.9%) had episodic migraine (EM) and 68 (27.1%) had chronic migraine (CM). Patients with CM had more serious clinical, psychiatric, and poor QOL than did patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = -0.373, p < 0.001), followed by the MIDAS score (β = -0.223, p < 0.001), female gender (β = -0.192, p < 0.001), attack duration (β = -0.159, p = 0.001), and headache chronicity (β = -0.130, p = 0.012). Headache chronicity had a direct effect on the MSQoL score and exerted an indirect effect on the MSQoL score through the MIDAS and the BDI scores. CONCLUSIONS Chronic migraine appears to impair QOL directly as well as indirectly by provoking disability and depression.
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Kindelan-Calvo P, Gil-Martínez A, Paris-Alemany A, Pardo-Montero J, Muñoz-García D, Angulo-Díaz-Parreño S, La Touche R. Effectiveness of Therapeutic Patient Education for Adults with Migraine. A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PAIN MEDICINE 2014; 15:1619-36. [DOI: 10.1111/pme.12505] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Functioning of women with migraine headaches. ScientificWorldJournal 2014; 2014:492350. [PMID: 25133238 PMCID: PMC4124239 DOI: 10.1155/2014/492350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Migraines are one of the most commonly occurring ailments affecting the nervous system. The aim of this research paper was to evaluate the effect migraines have on the everyday functioning of women. METHOD The study involved women with diagnosed migraine headaches (IHS-2004) undergoing treatment at a neurological clinic. In order to evaluate the influence of headaches on the everyday functioning of women, a MSQ v.2 questionnaire was used, whereas pain severity was assessed on a linear VAS scale. RESULTS Among the clinical factors, the most influential was the frequency of headaches. Headache duration was particularly significant for women below the age of 40. Pain severity cited at 8-10 pts on the VAS significantly disrupted and limited everyday functioning. On the emotional function subscale, the most influential factors were age, education, and the frequency of headaches. CONCLUSIONS On account of headache frequency emerging as the most significant influencing factor, it is of the utmost importance to inform patients of the value of taking prophylactic measures. Central to this is the identification of factors that trigger the onset of migraines. This approach would greatly aid the individual in choosing the appropriate treatment, either pharmacological or others.
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Gupta R, Spence D, BaHammam A, Monti J, Pandi-Perumal S. Association between migraine and restless legs syndrome. SOMNOLOGIE 2014. [DOI: 10.1007/s11818-013-0650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Efficacy of Zhengtian Pill for migraine prophylaxis: A randomized, multicenter, double-blind, placebo-controlled, parallel-group study. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2014.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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47
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Raggi A, Covelli V, Leonardi M, Grazzi L, Curone M, D’Amico D. Difficulties in work-related activities among migraineurs are scarcely collected: results from a literature review. Neurol Sci 2014; 35 Suppl 1:23-6. [DOI: 10.1007/s10072-014-1736-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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48
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Göbel H, Heinze-Kuhn K, Petersen I, Göbel A, Heinze A. [Integrated headache care network. Kiel Migraine and Headache Center and German National Headache Treatment Network]. Schmerz 2014; 27:149-65. [PMID: 23549863 DOI: 10.1007/s00482-013-1307-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Migraine and other headaches affect 54 million people in Germany. They rank among the ten most severely disabling complaints and the three most expensive neurological disorders. Nevertheless, they are not adequately recognized in the healthcare system with sketchy diagnoses and inadequate treatment. This inadequate care is not primarily due to a lack of medical and scientific knowledge on the development and treatment of headaches but is predominantly due to organizational deficits in the healthcare system and in the implementation of current knowledge. To overcome the organizational barriers the national headache treatment network was initiated in Germany. For the first time it allows national cross-sectoral and multidisciplinary links between inpatient and outpatient care. A hand in hand treatment programme, better education, better information exchange between all partners and combined efforts using clearly defined treatment pathways and goals are the basis for state of the art and efficient treatment results. The treatment network is geared towards the specialized treatment of severely affected patients with chronic headache disorders. A national network of outpatient and inpatient pain therapists in both practices and hospitals works hand in hand to optimally alleviate pain in a comprehensive cross-sectoral and multidisciplinary manner. For therapy refractive disorders, a high-intensive supraregional fully inpatient treatment can be arranged. This concept offers for the first time a nationwide coordinated treatment without limitation by specialization and bureaucratic remuneration sectors.
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Affiliation(s)
- H Göbel
- Migräne- und Kopfschmerzzentrum, Schmerzklinik Kiel, Heikendendorfer Weg 9-27, Kiel, Germany.
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Taşkapilioğlu Ö, Karli N. Assessment of Quality of Life in Migraine. Noro Psikiyatr Ars 2013; 50:S60-S64. [PMID: 28360587 DOI: 10.4274/npa.y7310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 07/14/2013] [Indexed: 12/01/2022] Open
Abstract
Quality of life is the perception of an individual's position in life associated with his objectives, expectations, interests, and standard's of life. Health-related quality of life, on the other hand, includes satisfaction with his health and emotional reaction to his state of health. Primary headaches are encountered commonly in adults during their most productive years like end of puberty and at the beginning of 50's. Migraine alone is responsible for 1.3% of years with disability in the world, all headaches together being responsible for twice of this load. Headaches both worsen quality of life of individuals and place a significant burden on the society. This review will focus on the effects of primary headaches, especially migraine, on quality of life and tools used to evaluate these effects.
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Affiliation(s)
| | - Necdet Karli
- Uludağ University, Medical Faculty, Department of Neurology, Bursa, Turkey
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50
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Chang FY, Lu CL. Irritable bowel syndrome and migraine: bystanders or partners? J Neurogastroenterol Motil 2013; 19:301-11. [PMID: 23875096 PMCID: PMC3714407 DOI: 10.5056/jnm.2013.19.3.301] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 03/18/2013] [Accepted: 03/25/2013] [Indexed: 01/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) and migraine are distinct clinical disorders. Apart from the characteristics of chronic and recurrent pain in nature, these pain-related disorders apparently share many similarities. For example, IBS is female predominant with community prevalence about 5-10%, whereas that of migraine is 1-3% also showing female predominance. They are often associated with many somatic and psychiatric comorbidities in terms of fibromyaglia, chronic fatigue syndrome, interstitial cystitis, insomnia and depression etc., even the IBS subjects may have coexisted migraine with an estimated odds ratio of 2.66. They similarly reduce the quality of life of victims leading to the social, medical and economic burdens. Their pathogeneses have been somewhat addressed in relation to biopsychosocial dysfunction, heredity, genetic polymorphism, central/visceral hypersensitivity, somatic/cutaneous allodynia, neurolimbic pain network, gonadal hormones and abuses etc. Both disorders are diagnosed according to the symptomatically based criteria. Multidisciplinary managements such as receptor target new drugs, melantonin, antispasmodics, and psychological drugs and measures, complementary and alternatives etc. are recommended to treat them although the used agents may not be necessarily the same. Finally, the prognosis of IBS is pretty good, whereas that of migraine is less fair since suicide attempt and stroke are at risk. In conclusion, both distinct chronic pain disorders to share many similarities among various aspects probably suggest that they may locate within the same spectrum of a pain-centered disorder such as central sensitization syndromes. The true pathogenesis to involve these disorders remains to be clarified in the future.
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Affiliation(s)
- Full-Young Chang
- Environmental Heath and Safety Office, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan
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