1
|
Al-Hashel JY, Alroughani R, Alshaf F, Ashkanani HK, Akl A, AlMutairi O, Alwazzan S, Ahmed SF. Real-world experiences of migraine patients on Erenumab: a Kuwait single center cohort. Neurol Res 2024; 46:772-780. [PMID: 38909320 DOI: 10.1080/01616412.2024.2354618] [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] [Received: 10/10/2023] [Accepted: 05/07/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Migraine is a prevalent headache disorder with a significant impact on the quality of life. This study aims to investigate the effectiveness and safety of erenumab, mAb targeting the CGRP receptor, in treating chronic (CM) and episodic (EM) migraine in clinical practice Kuwait, providing region-specific insights to treatment options. METHOD This was a prospective observational cohort study of patients diagnosed with EM or CM treated with erenumab. The primary outcome of the study was to assess the proportion of patients achieving ≥ 50% reduction in monthly mean migraine days, and several changes including the mean number of monthly migraine days, the frequency of analgesic use, attack severity, AEs, and QoL. RESULTS The study included 151 patients with a mean age of 44.0±11.4 years, and 81.9% female. The primary outcome was achieved in 74.2% of patients, with a significant (p < 0.001) reduction in headache frequency, pain severity, analgesic use, and improvement in QoL. Age and duration of migraine were significant predictors of achieving a ≥ 50% reduction in headache frequency after therapy (OR = 0.955; p = 0.009) and (OR = 0.965; p = 0.025), respectively. Treatment compliance was observed in 76.2% of patients, and 24.5% discontinued treatment. Constipation was the most commonly reported AEs (6.0%), and conservative management was the most common approach to managing AEs. CONCLUSION Erenumab was effective in reducing the frequency and severity of migraine attacks and improving QoL, and safe with manageable AEs in a real-world setting in Kuwait. Further research is needed to better understand erenumab's effectiveness and safety in different populations and settings, as well as to compare it with other migraine prophylactic treatments.
Collapse
Affiliation(s)
- Jasem Youssef Al-Hashel
- Neurology Department, Ibn Sina Hospital, Safat, Kuwait City, Kuwait
- Faculty of Medicine, Kuwait University, Safat, Kuwait City, Kuwait
| | - Raed Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait City, Kuwait
| | - Fatemah Alshaf
- Neurology Department, Ibn Sina Hospital, Safat, Kuwait City, Kuwait
| | | | - Amr Akl
- Medicine Department, Farwaniya Hospital, Farwaniya, Kuwait
| | | | - Sawsan Alwazzan
- Faculty of Medicine, Kuwait University, Safat, Kuwait City, Kuwait
| | - Samar Farouk Ahmed
- Neurology Department, Ibn Sina Hospital, Safat, Kuwait City, Kuwait
- Neuropsychiatry Department, Faculty of Medicine, Al-Minia University, Minia City, Minia, Egypt
| |
Collapse
|
2
|
Katsarava Z, Buse DC, Leroux E, Lanteri-Minet M, Sakai F, Matharu MS, Adams AM, Carr K, Fanning KM, Lipton RB. Disability in migraine: Multicountry results from the Chronic Migraine Epidemiology and Outcomes - International (CaMEO-I) Study. Cephalalgia 2024; 44:3331024241274343. [PMID: 39175365 DOI: 10.1177/03331024241274343] [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] [Indexed: 08/24/2024]
Abstract
BACKGROUND Few studies of migraine have evaluated migraine disability across multiple countries using the same methodology. METHODS This cross-sectional, web-based survey was conducted in 2021-2022 in Canada, France, Germany, Japan, UK and USA. Respondents with migraine were identified based on modified International Classification of Headache Disorders, 3rd edition, criteria. Headache features (Migraine Symptom Severity Score (MSSS, range: 0-21), presence of allodynia (Allodynia Symptom Checklist, ASC-12)) and migraine burden (Patient Health Questionnaire-4 (PHQ-4), Migraine-Specific Quality of Life questionnaire version 2.1 (MSQ v2.1), Work Productivity and Activity Impairment (WPAI) questionnaire) were evaluated. RESULTS Among 14,492 respondents with migraine across countries, the mean ± SD MSSS was 15.4 ± 3.2 and 48.5% (7026/14,492) of respondents had allodynia based on ASC-12. Of all respondents living with migraine, 35.5% (5146/14,492) reported moderate to severe anxiety and/or depression symptoms. Mean ± SD MSQ v2.1 Role Function-Restrictive, Role Function-Preventive and Emotional Function domain scores were 60.7 ± 22.9, 71.5 ± 23.0 and 65.1 ± 27.2, respectively. The WPAI mean ± SD percentages of respondents who missed work or worked impaired as a result of migraine were 6.8 ± 18.1% and 41.0 ± 30.1%, respectively. CONCLUSIONS For every country surveyed, migraine was associated with high levels of symptom severity, with allodynia and with substantial burden.
Collapse
Affiliation(s)
- Zaza Katsarava
- Department of Neurology, Christian Hospital Unna, Unna, Germany
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
| | - Dawn C Buse
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Elizabeth Leroux
- Department of Neurology, Montreal Neurological Clinic, Montreal, QC, Canada
| | - Michel Lanteri-Minet
- Pain Department and FHU InovPain, CHU Nice and Côte Azur University, Nice, France
- INSERM U1107 Migraine and Trigeminal Pain, Auvergne University, Clermont-Ferrand, France
| | - Fumihiko Sakai
- Saitama International Headache Center, Chuo-ku, Saitama City, Japan
| | | | | | | | | | - Richard B Lipton
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
3
|
Li M, Huang H, Yao L, Yang H, Ma S, Zheng H, Zhong Z, Yu S, Yu B, Wang H. Effect of acupuncture on the modulation of functional brain regions in migraine: A meta-analysis of fMRI studies. Front Neurol 2023; 14:1036413. [PMID: 36970520 PMCID: PMC10031106 DOI: 10.3389/fneur.2023.1036413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 02/17/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundAcupuncture, a traditional Chinese medicine therapy, is an effective migraine treatment, especially in improving pain. In recent years, many acupuncture brain imaging studies have found significant changes in brain function following acupuncture treatment of migraine, providing a new perspective to elucidate the mechanism of action of acupuncture.ObjectiveTo analyse and summarize the effects of acupuncture on the modulation of specific patterns of brain region activity changes in migraine patients, thus providing a mechanism for treating migraine by acupuncture.MethodsChinese and English articles published up to May 2022 were searched in three English databases (PubMed, Embase and Cochrane) and four Chinese databases (China national knowledge infrastructure, CNKI; Chinese Biomedical Literature database, CBM; the Chongqing VIP database, VIP; and the Wanfang database, WF). A neuroimaging meta-analysis on ALFF, ReHo was performed on the included studies using Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) software. Subgroup analyses were used to compare differences in brain regions between acupuncture and other groups. Meta-regression was used to explore the effect of demographic information and migraine alterations on brain imaging outcomes. Linear models were drawn using MATLAB 2018a, and visual graphs for quality evaluation were produced using R and RStudio software.ResultsA total of 7 studies comprising 236 patients in the treatment group and 173 in the control group were included in the meta-analysis. The results suggest that acupuncture treatment helps to improve pain symptoms in patients with migraine. The left angular gyrus is hyperactivation, and the left superior frontal gyrus and the right superior frontal gyrus are hypoactivated. The migraine group showed hyperactivation in the corpus callosum compared to healthy controls.ConclusionAcupuncture can significantly regulate changes in brain regions in migraine patients. However, due to the experimental design of neuroimaging standards are not uniform, the results also have some bias. Therefore, to better understand the potential mechanism of acupuncture on migraine, a large sample, multicenter controlled trial is needed for further study. In addition, the application of machine learning methods in neuroimaging studies could help predict the efficacy of acupuncture and screen migraine patients suitable for acupuncture treatment.
Collapse
Affiliation(s)
- Mengyuan Li
- Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Haipeng Huang
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Lin Yao
- Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Hongmei Yang
- Institute of Acupuncture and Massage, Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Shiqi Ma
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Haizhu Zheng
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Zhen Zhong
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Shuo Yu
- College of Acupuncture and Massage, Changchun University of Chinese Medicine, Changchun, China
| | - Bin Yu
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Hongfeng Wang
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
- *Correspondence: Hongfeng Wang
| |
Collapse
|
4
|
Gerstein MT, Wirth RJ, Uzumcu AA, Houts CR, McGinley JS, Buse DC, McCarrier KP, Cooke A, Touba NM, Nishida TK, Goadsby PJ, Dodick DW, Lipton RB. Patient-reported experiences with migraine-related cognitive symptoms: Results of the MiCOAS qualitative study. Headache 2023; 63:441-454. [PMID: 36905166 DOI: 10.1111/head.14484] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/12/2022] [Accepted: 01/14/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES To capture patients' perspectives on migraine-related cognitive symptoms during pre-headache, headache, post-headache, and interictal periods. BACKGROUND Migraine-related cognitive symptoms are reported by people with migraine both during and between attacks. Associated with disability, they are increasingly viewed as a priority target for treatment. The Migraine Clinical Outcome Assessment System (MiCOAS) project is focused on developing a patient-centered core set of outcome measures for the evaluation of migraine treatments. The project focuses on incorporating the experience of people living with migraine and the outcomes most meaningful to them. This includes an examination of the presence and functional impact of migraine-related cognitive symptoms and their perceived impact on quality of life and disability. METHODS Forty individuals with self-reported medically diagnosed migraine were recruited via iterative purposeful sampling for semi-structured qualitative interviews conducted using audio-only web conferencing. Thematic content analysis was performed to identify key concepts around migraine-related cognitive symptoms. Recruitment continued until concept saturation was achieved. RESULTS Participants described symptoms consistent with migraine-related deficits in language/speech, sustained attention, executive function, and memory that manifest during pre-headache (36/40 [90%] reported ≥1 cognitive feature), headache (35/40 [88%] reported ≥1 cognitive feature), post-headache (27/40 [68%] reported ≥1 cognitive feature), and interictal periods (13/40 [33%] reported ≥1 cognitive feature). Among participants reporting cognitive symptoms during pre-headache, 32/40 (81%) endorsed 2-5 cognitive symptoms. Findings were similar during the headache phase. Participants reported language/speech problems consistent with, for example, impairments in receptive language, expressive language, and articulation. Issues with sustained attention included fogginess, confusion/disorientation, and trouble with concentration/focus. Deficits in executive function included difficulty processing information and reduced capacity for planning and decision-making. Memory issues were reported across all phases of the migraine attack. CONCLUSIONS This patient-level qualitative study suggests that cognitive symptoms are common for persons with migraine, particularly in the pre-headache and headache phases. These findings highlight the importance of assessing and ameliorating these cognitive problems.
Collapse
Affiliation(s)
- Maya T Gerstein
- Patient Centered Outcomes, OPEN Health Group, Bethesda, Maryland, USA
| | - R J Wirth
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - Alyssa A Uzumcu
- Patient Centered Outcomes, OPEN Health Group, Bethesda, Maryland, USA
| | - Carrie R Houts
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - James S McGinley
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - Dawn C Buse
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kelly P McCarrier
- Patient Centered Outcomes, OPEN Health Group, Bethesda, Maryland, USA
| | - Alexis Cooke
- Patient Centered Outcomes, OPEN Health Group, Bethesda, Maryland, USA
| | - Nancy M Touba
- Patient Centered Outcomes, OPEN Health Group, Bethesda, Maryland, USA
| | - Tracy K Nishida
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - Peter J Goadsby
- NIHR SLaM King's Clinical Research Facility, King's College London, London, UK
- Department of Neurology, University of California, Los Angeles, California, USA
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
- Atria Institute, New York, New York, USA
| | - Richard B Lipton
- Albert Einstein College of Medicine, Bronx, New York, USA
- Montefiore Medical Center, Bronx, New York, USA
| |
Collapse
|
5
|
Steiner TJ, Terwindt GM, Katsarava Z, Pozo-Rosich P, Gantenbein AR, Roche SL, Dell’Agnello G, Tassorelli C. Migraine-attributed burden, impact and disability, and migraine-impacted quality of life: Expert consensus on definitions from a Delphi process. Cephalalgia 2022; 42:1387-1396. [PMID: 35791285 PMCID: PMC9638708 DOI: 10.1177/03331024221110102] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Migraine-attributed burden, impact, disability and migraine-impacted quality
of life are important concepts in clinical management, clinical and
epidemiological research, and health policy, requiring clear and agreed
definitions. We aimed to formulate concise and precise definitions of these
concepts by expert consensus. Methods We searched the terms migraine-attributed burden, impact, disability and
migraine-impacted quality of life in Embase and Medline from 1974 and 1946
respectively. We followed a Delphi process to reach consensus on
definitions. Results We found widespread conflation of concepts and inconsistent terminology
within publications. Following three Delphi rounds, we defined
migraine-attributed burden as “the summation of all
negative consequences of the disease or its diagnosis”;
migraine-attributed impact as “the effect of the
disease, or its diagnosis, on a specified aspect of life, health or
wellbeing”; migraine-attributed disability as “physical,
cognitive and mental incapacities imposed by the disease”; and
migraine-impacted quality of life as “the subjective
assessment by a person with the disease of their general wellbeing, position
and prospects in life”. We complemented each definition with a detailed
description. Conclusion These definitions and descriptions should foster consistency and encourage
more appropriate use of currently available quantifying instruments and aid
the future development of others.
Collapse
Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Division of Brain Sciences, Imperial College London, London, UK
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Zaza Katsarava
- Christian Hospital Unna, Unna, Germany
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
- EVEX Medical Corporation, Tbilisi, Georgia
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Headache Research Group, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Andreas R Gantenbein
- Department of Neurology, ZURZACH Care, Bad Zurzach, Switzerland
- Neurological Practice, Neurologie am Untertor, Bülach, Switzerland
- Department of Neurology, University Hospital Zurich, Zürich, Switzerland
| | | | | | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| |
Collapse
|
6
|
Papakonstantinou D, Tomos C. Workplace productivity loss as a result of absenteeism and presenteeism in chronic and episodic migraine: a scoping review. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-05-2021-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeMigraine consists of a chronic neurological disorder with episodic attacks. Migraine prevails in people of their most productive working age, followed by difficulties at work and social functions. This scoping review aims to analyze the economic burden on a workplace due to chronic migraine compared to episodic migraine by focusing on the indirect costs of absenteeism and presenteeism and addressing the research gaps in this field.Design/methodology/approachAccording to the PRISMA Extension for Scoping Reviews, a comprehensive electronic literature search was carried out from 2010 to 2020 using the Google Scholar and Medline/PubMed databases.FindingsThe findings confirm that chronic and episodic migraine harm the workplace's productivity, escalating with the frequency of migraine attacks. Differences occur between presenteeism and absenteeism rates among chronic and episodic migraine, and higher presenteeism than absenteeism rates.Originality/valueThis review sheds new light on the indirect burden of migraine. It shows the gaps in the explored research area and the need for more targeted and extended research that could provide a deeper understanding of the workplace's hidden costs of migraine. The issues discussed are important as they can raise awareness of the interested parties, policymakers, employers and vocational rehabilitation specialists on the work disability associated with migraine.
Collapse
|
7
|
A Narrative Review of Neuroimaging Studies in Acupuncture for Migraine. Pain Res Manag 2021; 2021:9460695. [PMID: 34804268 PMCID: PMC8598357 DOI: 10.1155/2021/9460695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/10/2021] [Indexed: 12/18/2022]
Abstract
Acupuncture has been widely used as an alternative and complementary therapy for migraine. With the development of neuroimaging techniques, the central mechanism of acupuncture for migraine has gained increasing attention. This review aimed to analyze the study design and main findings of neuroimaging studies of acupuncture for migraine to provide the reference for future research. The original studies were collected and screened in three English databases (PubMed, Embase, and Cochrane Library) and four Chinese databases (Chinese National Knowledge Infrastructure, Chinese Biomedical Literature database, the Chongqing VIP database, and Wanfang database). As a result, a total of 28 articles were included. Functional magnetic resonance imaging was the most used neuroimaging technique to explore the cerebral activities of acupuncture for migraine. This review manifested that acupuncture could elicit cerebral responses on patients with migraine, different from sham acupuncture. The results indicated that the pain systems, including the medial pain pathway, lateral pain pathway, and descending pain modulatory system, participated in the modulation of the cerebral activities of migraine by acupuncture.
Collapse
|
8
|
Koute V, Michalopoulou A, Siokas V, Aloizou AM, Rikos D, Bogdanos DP, Kontopoulos E, Grivea IN, Syrogiannopoulos GA, Papadimitriou A, Hadjigeorgiou GM, Dardiotis E. Val66Met polymorphism is associated with decreased likelihood for pediatric headache and migraine. Neurol Res 2021; 43:715-723. [PMID: 34000980 DOI: 10.1080/01616412.2021.1922181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Migraine is a complex multifactorial disorder and its pathogenesis still remains unclear. Evidence suggests the involvement of the activated trigeminovascular pathway, in which BDNF seems to play an important role. Therefore, BDNF polymorphisms are promising candidate susceptibility factors.Aim: BDNF rs6265 functional polymorphism was analyzed in order to determine its possible association with pediatric headache and migraine risk.Methods: The research included 120 consecutive pediatric patients who were diagnosed with headache and 120 healthy controls. The diagnosis was in compliance with the International Classification of Headache Disorders. Blood samples were collected from all participants and genotyped for rs6265.Results: BDNF rs6265 was significantly associated with decreased headache risk, particularly in the dominant model [Odds Ratio, OR (95% confidence interval, C.I.): 0.47 (0.26-0.85), p = 0.011] and the log-additive model [OR (95% C.I.): 0.48 (0.28-0.82), p = 0.0053]. During the sensitivity analysis, the associations were also maintained among patients with migraine.Conclusions: This is the first study to reveal a significant association of this BDNF variant with headache risk. Additionally, Val66Met was also for the first time related to decreased childhood migraine risk.
Collapse
Affiliation(s)
- Vasiliki Koute
- Department of Pediatrics, University of Thessaly, University Hospital of Larissa, Larissa,Greece
| | - Amalia Michalopoulou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Dimitrios Rikos
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Dimitrios P Bogdanos
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Viopolis Larissa, Greece
| | | | - Ioanna N Grivea
- Department of Pediatrics, University of Thessaly, University Hospital of Larissa, Larissa,Greece
| | | | - Alexandros Papadimitriou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| |
Collapse
|
9
|
Monthly versus quarterly fremanezumab for the prevention of migraine: a systemic review and meta-analysis from randomized controlled trials. Naunyn Schmiedebergs Arch Pharmacol 2020; 394:819-828. [DOI: 10.1007/s00210-020-02009-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/22/2020] [Indexed: 12/18/2022]
|
10
|
Economic burden of medication-overuse headache in Iran: direct and indirect costs. Neurol Sci 2020; 42:1869-1877. [PMID: 32948933 DOI: 10.1007/s10072-020-04716-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Medication-overuse headache (MOH) as a secondary chronic headache imposes a considerable burden on both individuals and societies. Nevertheless, little is known about the burden of MOH in Iran. Therefore, in the current study, we aimed to quantify the annual cost of MOH among Iranian patients. METHODS In this cross-sectional study, 84 patients were recruited. Demographic data, headache attack characteristics, related disability, and information about the economic burden of MOH were collected through face-to-face interview. Direct medical and nonmedical costs as well as indirect costs were included in our cost analysis. The prevalence-based approach was applied to estimate the economic burden of MOH. RESULTS We found that MOH patients in Iran spend averagely $1046 for medical services, $132 for nonmedical services, and $1432 due to lost productivity per year. The per-person annual cost of MOH was US$2610, and the total annual cost for Iran was $10,179,000,000, with direct and indirect cost accounting for 45% and 55%, respectively. CONCLUSION MOH leads to substantial healthcare costs and significant loss of productivity in Iran. Therefore, raising awareness in this area especially for policymakers can use in future health planning and lead to resource allocation in the field of disabling type of headache disorders such as MOH. Our findings also provide a different insight into the burden of MOH, which are likely closer to the actual costs in middle- and low-income countries, and also it could be a sample of such a study in western Asia.
Collapse
|
11
|
Martinelli D, Arceri S, Tronconi L, Tassorelli C. Chronic migraine and Botulinum Toxin Type A: Where do paths cross? Toxicon 2020; 178:69-76. [PMID: 32250749 DOI: 10.1016/j.toxicon.2020.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 12/17/2022]
Abstract
Migraine is a highly prevalent and disabling disorder accounted among the primary headaches. It is the expression of a complex, and not yet fully understood, pathophysiology involving the sensitization of peripheral and central nociceptive pathways. In this review we succinctly illustrate the molecular, anatomical, and functional abnormalities underlying the migraine attack that are relevant for understanding in more depth the neurobiology behind the therapeutic effect of Botulinum Toxin Type A (BoNT-A). BoNT-A has proved effective in several neurological conditions and, more recently, also in chronic migraine. Its antimigraine mechanism of action was initially thought to be limited to the periphery and interpreted as an inhibitory activity on the processes associated to the local release of neuropeptides, with subsequent induction of peripheral sensitization. Increasing experimental evidence has become available to suggest that additional mechanisms are possibly involved, including the direct/indirect inhibition of sensitization processes in central nociceptive pathways.
Collapse
Affiliation(s)
- Daniele Martinelli
- Mondino Foundation IRCCS, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Sebastiano Arceri
- Mondino Foundation IRCCS, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Tronconi
- Mondino Foundation IRCCS, Pavia, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - Cristina Tassorelli
- Mondino Foundation IRCCS, Pavia, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| |
Collapse
|
12
|
She T, Chen Y, Tang T, Chen M, Zheng H. Calcitonin gene-related peptide antagonists versus botulinum toxin A for the preventive treatment of chronic migraine protocol of a systematic review and network meta-analysis: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e18929. [PMID: 32000407 PMCID: PMC7004656 DOI: 10.1097/md.0000000000018929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although calcitonin gene-related peptide antagonists and botulinum toxin A have been shown efficacy in preventing chronic migraine, there is no direct evidence for their comparative effectiveness. This review is to assess the comparative effectiveness and safety of calcitonin gene-related peptide antagonists and botulinum toxin A for chronic migraine using network meta-analysis. METHODS OVID MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials will be searched for relevant randomized controlled trials from their inception to December 2019 without language restriction. We will include trials testing the effectiveness of calcitonin gene-related peptide antagonists or botulinum toxin A in patients with chronic migraine. The outcomes are mean change from baseline in the number of headache days, the mean change from baseline in the number of migraine days, the mean change from baseline in headache hours, responder rate, and adverse events rate. The methodological quality of the included randomized controlled trials will be evaluated using Cochrane Collaboration's risk of bias tool. Standardized mean difference will be used to synthesize continuous variables and risk ratio will be used to synthesize categorical variables. Pairwise and network meta-analysis will be performed using a frequentist method in netmeta package (R 3.5.0, www.r-project.org). RESULTS Ethical approval and informed consent are not required for this systematic review. The results will be submitted to a peer-reviewed journal and conference abstracts for publication. CONCLUSION The result of the review will systematically provide suggestions for clinicians, patients, and policy makers in the treatment of chronic migraine.PROSPERO registration number: CRD42018089201.
Collapse
Affiliation(s)
- Tianwei She
- The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Yaoyao Chen
- The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| | - Taichun Tang
- Department of Anorectal Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Chen
- Department of Anorectal Diseases, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hui Zheng
- The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine
| |
Collapse
|
13
|
Takeshima T, Wan Q, Zhang Y, Komori M, Stretton S, Rajan N, Treuer T, Ueda K. Prevalence, burden, and clinical management of migraine in China, Japan, and South Korea: a comprehensive review of the literature. J Headache Pain 2019; 20:111. [PMID: 31805851 PMCID: PMC6896325 DOI: 10.1186/s10194-019-1062-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/28/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The objective of this review was to determine the unmet needs for migraine in East Asian adults and children. METHODS We searched MEDLINE and EMBASE (January 1, 1988 to January 14, 2019). Studies reporting the prevalence, humanistic and economic burden, and clinical management of migraine in China (including Hong Kong and Taiwan), Japan, and South Korea were included. Studies conducted before 1988 (before the International Headache Society [IHS] first edition of the International Classification of Headache Disorders) were not included. RESULTS We retrieved 1337 publications and 41 met the inclusion criteria (28 from China, 7 from Japan, and 6 from South Korea). The 1-year prevalence of migraine (IHS criteria) among adults ranged from 6.0% to 14.3%. Peak prevalence ranged from 11% to 20% for women and 3% to 8% for men (30- to 49-year-olds). For children, prevalence of migraine increased with age. Information on the economic burden and clinical management of migraine was limited, particularly for children. When reported, migraine was significantly associated with high levels of disability and negative effects on quality of life. Studies suggested low levels of disease awareness/diagnosis within each country. Of individuals with migraine from China, 52.9% to 68.6% had consulted a physician previously, 37.2% to 52.7% diagnosed with headache had not been diagnosed with migraine previously, and 13.5% to 18% had been diagnosed with migraine previously. Of individuals with migraine from Japan, 59.4% to 71.8% had never consulted a physician previously, 1.3% to 7.3% regularly consulted physicians for their headache, and only 11.6% of individuals with migraine were aware that they had migraine. In addition, studies suggested that over-the-counter medication use was high and prescription medication use was low in each country. CONCLUSIONS This review suggests that there are unmet needs for migraine in terms of sufficient and appropriate diagnosis, and better management and therapies for treatment of migraine in East Asia. The findings are limited by a lack of recent information and significant gaps in the literature. More recent, population-based studies assessing disease burden and clinical management of migraine are needed to confirm unmet needs for migraine across East Asia.
Collapse
Affiliation(s)
- Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Osaka, Japan
| | - Qi Wan
- Department of Neurology, Jiangsu Province Hospital, Nanjing, China
| | | | - Mika Komori
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., 5-1-28, Isogamidori, chuo-ku, Kobe, 651-0086, Japan
| | | | | | - Tamas Treuer
- GPORWE International, Lilly Hungaria Kft, Budapest, Hungary
| | - Kaname Ueda
- Medicine Development Unit-Japan, Eli Lilly Japan K.K., 5-1-28, Isogamidori, chuo-ku, Kobe, 651-0086, Japan.
| |
Collapse
|
14
|
Acupuncture versus propranolol in migraine prophylaxis: an indirect treatment comparison meta-analysis. J Neurol 2019; 267:14-25. [DOI: 10.1007/s00415-019-09510-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 01/21/2023]
|
15
|
Donnet A, Emery C, Aly S, Allaf B, Cayre F, Mahieu N, Gourmelen J, Levy P, Fagnani F. Migraine burden and costs in France: a nationwide claims database analysis of triptan users. J Med Econ 2019; 22:616-624. [PMID: 30836035 DOI: 10.1080/13696998.2019.1590841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: To estimate the burden of migraine in the population of French patients identified as specific migraine acute treatment users compared to a control group. Methods: A cross-sectional retrospective analysis was performed on the Echantillon Généraliste des Bénéficiaires claims database, a 1/97 random sample of the French public insurance database. A representative sample of all adults with at least one delivery of triptans, ergot derivatives or acetylsalicylic acid/metoclopramide (all drugs with a specific label in migraine acute treatment - SMAT) in 2014 was selected with a control group matched on age, gender and geographic region. Among triptan users, a sub-group of over-users was defined according to their level of triptan uptake expressed in defined daily doses (DDD - a standard daily dose of treatment of acute migraine) per month over 3 months and more, was also compared with controls. The cost analysis was performed in a societal perspective for direct costs. Sick leave indirect costs were estimated using the human capital approach. Results: In total 8639 SMAT users (mean age: 44.6 years; 78.7% women) were selected representing a crude prevalence rate of 1.7%. The annual per capita total healthcare expenditures were higher by €280 in this group compared to controls (€2463 vs. €2183). Triptans contributed 47.8% to this extra cost. They used significantly (p < .0001) more frequently than controls antidepressants (20.8% vs. 11.0%), anxiolytics (29.4% vs. 18.8%) and analgesics (53.8% vs. 35.8%). The per capita annual productivity loss associated with sick leave was higher by €295 (€1712 vs. €1417). Among triptan users, there were 2.9% over-users. This last group was characterized by substantially higher per capita annual extra direct (+ €1805) and indirect costs (productivity loss +€706) compared to controls. Conclusions: Due to its high prevalence, migraine costs generate a significant societal burden. The group of over-users concentrates high per capita direct and indirect costs.
Collapse
Affiliation(s)
| | | | - Samia Aly
- c Novartis Pharma , Rueil-Malmaison , France
| | | | - Fanny Cayre
- c Novartis Pharma , Rueil-Malmaison , France
| | | | | | - Pierre Levy
- e Université Paris-Dauphine, PSL Research University, LEDa [LEGOS] , Paris , France
| | | |
Collapse
|
16
|
Silberstein SD, Cohen JM, Yeung PP. Fremanezumab for the preventive treatment of migraine. Expert Opin Biol Ther 2019; 19:763-771. [PMID: 31177856 DOI: 10.1080/14712598.2019.1627323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: The recent approval of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway introduced the first preventive treatments for migraine that were specifically designed to target the underlying pathophysiology of the disease. Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) administered via subcutaneous injection, is the first approved monoclonal antibody that targets the CGRP ligand and offers both quarterly (once every 3 months) and monthly dosing. Areas covered: An introduction to migraine, overview of the migraine preventive treatments that target CGRP or its receptor, background on CGRP, and details on the fremanezumab clinical development program in both chronic and episodic migraine. Focus is on the Phase 2b and Phase 3 studies, as well as the recently completed long-term Phase 3 study. Expert opinion: The approval of the first disease-specific preventive treatments for migraine heralds a new era in the treatment of migraine. Fremanezumab has a favorable efficacy and safety profile, which is maintained over the long term. Data from patient subgroups with more-complex disease are promising, and an ongoing study in treatment-refractory patients is evaluating the efficacy of fremanezumab in patients who have failed on multiple prior therapies.
Collapse
Affiliation(s)
| | - Joshua M Cohen
- b Teva Pharmaceutical Industries Ltd. , Frazer , PA , USA
| | - Paul P Yeung
- b Teva Pharmaceutical Industries Ltd. , Frazer , PA , USA
| |
Collapse
|
17
|
Gross EC, Klement RJ, Schoenen J, D'Agostino DP, Fischer D. Potential Protective Mechanisms of Ketone Bodies in Migraine Prevention. Nutrients 2019; 11:E811. [PMID: 30974836 PMCID: PMC6520671 DOI: 10.3390/nu11040811] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/15/2022] Open
Abstract
An increasing amount of evidence suggests that migraines are a response to a cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity. The ketogenic diet (KD), a diet mimicking fasting that leads to the elevation of ketone bodies (KBs), is a therapeutic intervention targeting cerebral metabolism that has recently shown great promise in the prevention of migraines. KBs are an alternative fuel source for the brain, and are thus likely able to circumvent some of the abnormalities in glucose metabolism and transport found in migraines. Recent research has shown that KBs-D-β-hydroxybutyrate in particular-are more than metabolites. As signalling molecules, they have the potential to positively influence other pathways commonly believed to be part of migraine pathophysiology, namely: mitochondrial functioning, oxidative stress, cerebral excitability, inflammation and the gut microbiome. This review will describe the mechanisms by which the presence of KBs, D-BHB in particular, could influence those migraine pathophysiological mechanisms. To this end, common abnormalities in migraines are summarised with a particular focus on clinical data, including phenotypic, biochemical, genetic and therapeutic studies. Experimental animal data will be discussed to elaborate on the potential therapeutic mechanisms of elevated KBs in migraine pathophysiology, with a particular focus on the actions of D-BHB. In complex diseases such as migraines, a therapy that can target multiple possible pathogenic pathways seems advantageous. Further research is needed to establish whether the absence/restriction of dietary carbohydrates, the presence of KBs, or both, are of primary importance for the migraine protective effects of the KD.
Collapse
Affiliation(s)
- Elena C Gross
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland.
| | - Rainer J Klement
- Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, 97422 Schweinfurt, Germany.
| | - Jean Schoenen
- Headache Research Unit, University of Liège, Dept of Neurology-Citadelle Hospital, 4000 Liège, Belgium.
| | - Dominic P D'Agostino
- Department of Molecular Pharmacology and Physiology, Metabolic Medicine Research Laboratory, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA.
- Institute for Human and Machine Cognition, Ocala, FL 34471, USA.
| | - Dirk Fischer
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, 4056 Basel, Switzerland.
| |
Collapse
|
18
|
Sacco S, Benemei S, Cevoli S, Coppola G, Cortelli P, De Cesaris F, De Icco R, De Marco CM, Di Lorenzo C, Geppetti P, Manni A, Negro A, Ornello R, Pierangeli G, Pierelli F, Pellesi L, Pini LA, Pistoia F, Prudenzano MP, Russo A, Sances G, Taranta V, Tassorelli C, Tedeschi G, Trojano M, Martelletti P. Development and validation of the ID-EC - the ITALIAN version of the identify chronic migraine. J Headache Pain 2019; 20:15. [PMID: 30760199 PMCID: PMC6734365 DOI: 10.1186/s10194-019-0966-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/24/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Case-finding tools, such as the Identify Chronic Migraine (ID-CM) questionnaire, can improve detection of CM and alleviate its significant societal burden. We aimed to develop and validate the Italian version of the ID-CM (ID-EC) in paper and as a smart app version in a headache clinic-based setting. METHODS The study investigators translated and adapted to the Italian language the original ID-CM questionnaire (ID-EC) and further implemented it as a smart app. The ID-EC was tested in its paper and electronic version in consecutive patients referring to 9 Italian tertiary headache centers for their first in-person visit. The scoring algorithm of the ID-EC paper version was applied by the study investigators (case-finding) and by patients (self-diagnosis), while the smart app provided to patients automatically the diagnosis. Diagnostic accuracy of the ID-EC was assessed by matching the questionnaire results with the interview-based diagnoses performed by the headache specialists during the visit according to the criteria of International Classification of Headache Disorders, III edition, beta version. RESULTS We enrolled 531 patients in the test of the paper version of ID-EC and 427 in the validation study of the smart app. According to the clinical diagnosis 209 patients had CM in the paper version study and 202 had CM in the smart app study. 79.5% of patients returned valid paper questionnaires, while 100% of patients returned valid and complete smart app questionnaires. The paper questionnaire had a 81.5% sensitivity and a 81.1% specificity for case-finding and a 30.7% sensitivity and 90.7% specificity for self-diagnosis, while the smart app had a 64.9% sensitivity and 90.2% specificity. CONCLUSIONS Our data suggest that the ID-EC, developed and validated in tertiary headache centers, is a valid case-finding tool for CM, with sensitivity and specificity values above 80% in paper form, while the ID-EC smart app is more useful to exclude CM diagnosis in case of a negative result. Further studies are warranted to assess the diagnostic accuracy of the ID-EC in general practice and population-based settings.
Collapse
Affiliation(s)
- Simona Sacco
- Department of Applied Clinical Sciences and Biotechnology, Section of Neurology, University of L’Aquila, L’Aquila, Italy
| | - Silvia Benemei
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Sabina Cevoli
- IRCCS Institute of Neurological Science of Bologna, Bologna, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University Polo Pontino, Latina, Italy
| | - Pietro Cortelli
- IRCCS Institute of Neurological Science of Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesco De Cesaris
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Roberto De Icco
- Headache Science Center, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Cristiano Maria De Marco
- Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University Polo Pontino, Latina, Italy
| | - Pierangelo Geppetti
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Alessia Manni
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Andrea Negro
- Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Raffaele Ornello
- Department of Applied Clinical Sciences and Biotechnology, Section of Neurology, University of L’Aquila, L’Aquila, Italy
| | - Giulia Pierangeli
- IRCCS Institute of Neurological Science of Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Lanfranco Pellesi
- Headache and Drug Abuse Research Centre, Policlinico Hospital, University of Modena e Reggio Emilia, Modena, Italy
| | - Luigi Alberto Pini
- Headache and Drug Abuse Research Centre, Policlinico Hospital, University of Modena e Reggio Emilia, Modena, Italy
| | - Francesca Pistoia
- Department of Applied Clinical Sciences and Biotechnology, Section of Neurology, University of L’Aquila, L’Aquila, Italy
| | - Maria Pia Prudenzano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Antonio Russo
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Grazia Sances
- Headache Science Center, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Valentina Taranta
- Department of Applied Clinical Sciences and Biotechnology, Section of Neurology, University of L’Aquila, L’Aquila, Italy
| | - Cristina Tassorelli
- Headache Science Center, IRCCS C. Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gioacchino Tedeschi
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Maria Trojano
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
19
|
Gross E, Putananickal N, Orsini AL, Schmidt S, Vogt DR, Cichon S, Sandor P, Fischer D. Efficacy and safety of exogenous ketone bodies for preventive treatment of migraine: A study protocol for a single-centred, randomised, placebo-controlled, double-blind crossover trial. Trials 2019; 20:61. [PMID: 30654835 PMCID: PMC6337840 DOI: 10.1186/s13063-018-3120-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 12/09/2018] [Indexed: 01/22/2023] Open
Abstract
Background Currently available prophylactic migraine treatment options are limited and are associated with many, often intolerable, side-effects. Various lines of research suggest that abnormalities in energy metabolism are likely to be part of migraine pathophysiology. Previously, a ketogenic diet (KD) has been reported to lead to a drastic reduction in migraine frequency. An alternative method to a strict KD is inducing a mild nutritional ketosis (0.4–2 mmol/l) with exogenous ketogenic substances. The aim of this randomised, placebo-controlled, double-blind, crossover, single-centre trial is to demonstrate safety and superiority of beta-hydroxybutyrate (βHB) in mineral salt form over placebo in migraine prevention. Methods/design Forty-five episodic migraineurs (5–14 migraine days/months), with or without aura, aged between 18 and 65 years, will be recruited at headache clinics in Switzerland, Germany and Austria and via Internet announcements. After a 4-week baseline period, patients will be randomly allocated to one of the two trial arms and receive either the βHB mineral salt or placebo for 12 weeks. This will be followed by a 4-week wash-out period, a subsequent second baseline period and, finally, another 12-week intervention with the alternative treatment. Co-medication with triptans (10 days per months) or analgesics (14 days per months) is permitted. The primary outcome is the mean change from baseline in the number of migraine days (meeting International Classification of Headache Disorders version 3 criteria) during the last 4 weeks of intervention compared to placebo. Secondary endpoints include mean changes in headache days of any severity, acute migraine medication use, migraine intensity and migraine and headache-related disability. Exploratory outcomes are (in addition to routine laboratory analysis) genetic profiling and expression analysis, oxidative and nitrosative stress, as well as serum cytokine analysis, and blood βHB and glucose analysis (pharmacokinetics). Discussion A crossover design was chosen as it greatly improves statistical power and participation rates, without increasing costs. To our knowledge this is the first RCT using βHB salts worldwide. If proven effective and safe, βHB might not only offer a new prophylactic treatment option for migraine patients, but might additionally pave the way for clinical trials assessing its use in related diseases. Trial registration ClinicalTrials.gov, NCT03132233. Registered on 27 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3120-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Elena Gross
- Division of Neuropaediatrics, University of Basel Children's Hospital, University of Basel, Spitalstrasse 33, Postfach, 4056, Basel, Switzerland
| | - Niveditha Putananickal
- Division of Neuropaediatrics, University of Basel Children's Hospital, University of Basel, Spitalstrasse 33, Postfach, 4056, Basel, Switzerland.
| | - Anna-Lena Orsini
- Division of Neuropaediatrics, University of Basel Children's Hospital, University of Basel, Spitalstrasse 33, Postfach, 4056, Basel, Switzerland
| | - Simone Schmidt
- Division of Neuropaediatrics, University of Basel Children's Hospital, University of Basel, Spitalstrasse 33, Postfach, 4056, Basel, Switzerland
| | - Deborah R Vogt
- Department of Clinical Research, Clinical Trial Unit, University of Basel Hospital, University of Basel, Basel, Switzerland
| | - Sven Cichon
- Department of Medical Genetics, University of Basel Hospital, University of Basel, Basel, Switzerland
| | | | - Dirk Fischer
- Division of Neuropaediatrics, University of Basel Children's Hospital, University of Basel, Spitalstrasse 33, Postfach, 4056, Basel, Switzerland
| |
Collapse
|
20
|
Florencio LL, Ferracni GN, Chaves TC, Palacios-Ceña M, Ordás-Bandera C, Speciali JG, Grossi DB, Fernández-de-Las-Peñas C. Analysis of Head Posture and Activation of the Cervical Neck Extensors During a Low-Load Task in Women With Chronic Migraine and Healthy Participants. J Manipulative Physiol Ther 2018; 41:762-770. [PMID: 30745005 DOI: 10.1016/j.jmpt.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/07/2018] [Accepted: 07/06/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the correlation between head and neck posture and superficial neck flexor and extensor activity during performance of the craniocervical flexion test (CCFT) in women with migraine and healthy controls. METHODS Fifty-two women with episodic migraine, 16 with chronic migraine, and 23 healthy controls participated. Head and neck posture were determined by assessing the craniovertebral (CV) angle and cervical lordosis angle. Surface electromyography signals were recorded bilaterally from sternocleidomastoid, anterior scalene, splenius capitis, and upper trapezius muscles as participants performed the CCFT. Differences in electromyogram activity and posture among groups were compared with analyses of variance. Correlations between posture and electromyogram activity were analyzed with the Pearson correlation coefficient. RESULTS Both migraine groups had a significant increase in splenius capitis muscle activity, when acting as an antagonist, at the last stage of CCFT (F = 4.687; P = .012) compared with controls. No differences among groups were observed for head and neck posture. No significant correlation was found in the episodic migraine group. Moderate correlations between the CV angle and upper trapezius activity at the majority stages of the CCFT (-0.61 < r < -0.65, all P < .05) were observed within the chronic migraine group: the more extended the head posture, the higher the activity of the upper trapezius muscle. The CV angle also was correlated with upper trapezius muscle activity at the first stage of the CCFT and with splenius capitis muscle activity at the last stages (-0.42 < r < -0.52; P < .05). CONCLUSION An extended (forward) head posture was moderately correlated with an increased in electrical activity of superficial neck extensor muscles, particularly the upper trapezius, when acting as an antagonist, during the performance of the CCFT in women with chronic but not episodic migraine.
Collapse
Affiliation(s)
- Lidiane L Florencio
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil
| | - Gabriela N Ferracni
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil
| | - Thais C Chaves
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil
| | - María Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - José G Speciali
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil
| | - Debora Belilaqua Grossi
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto-SP, Sao Paulo, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.
| |
Collapse
|
21
|
Hu B, Wang X, He JB, Dai YJ, Zhang J, Yu Y, Sun Q, Lin-FengYan, Hu YC, Nan HY, Yang Y, Kaye AD, Cui GB, Wang W. Structural and functional brain changes in perimenopausal women who are susceptible to migraine: a study protocol of multi-modal MRI trial. BMC Med Imaging 2018; 18:26. [PMID: 30189858 PMCID: PMC6127929 DOI: 10.1186/s12880-018-0272-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 01/01/2023] Open
Abstract
Background As a common clinical symptom that often bothers midlife females, migraine is closely associated with perimenopause. Previous studies suggest that one of the most prominent triggers is the sudden decline of estrogen during perimenopausal period. Hormone replacement therapy (HRT) is widely used to prevent this suffering in perimenopausal women, but effective diagnostic system is lacked for quantifying the severity of the diseaase. To avoid the abuse and overuse of HRT, we propose to conduct a diagnostic trial using multimodal MRI techniques to quantify the severity of these perimenopausal migraineurs who are susceptible to the decline of estrogen. Methods Perimenopausal women suffering from migraine will be recruited from the pain clinic of our hospital. Perimenopausal women not suffering from any kind of headache will be recruited from the local community. Clinical assessment and multi-modal MR imaging examination will be conducted. A follow up will be conducted once half year within 3 years. Pain behavior, neuropsychology scores, fMRI analysis combined with suitable statistical software will be used to reveal the potential association between these above traits and the susceptibility of migraine. Discussion Multi-modal imaging features of both healthy controls and perimenopausal women who are susceptible to estrogen decline will be acquired. Imaging features will include volumetric characteristics, white matter integrity, functional characteristics, topological properties, and perfusion properties. Clinical information, such as basic information, blood estrogen level, information of migraine, and a bunch of neurological scale will also be used for statistic assessment. This clinical trial would help to build an effective screen system for quantifying the severity of illness of those susceptible women during the perimenopausal period. Trial registration This study has already been registered at Clinical Trials. gov (ID: NCT02820974). Registration date: September 28th, 2014.
Collapse
Affiliation(s)
- Bo Hu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Xu Wang
- Student Brigade, Fourth Military Medical University (Air Force Medical University), 169 West Changle Road, Xi'an, 710032, Shaanxi Province, China
| | - Jie-Bing He
- Student Brigade, Fourth Military Medical University (Air Force Medical University), 169 West Changle Road, Xi'an, 710032, Shaanxi Province, China
| | - Yu-Jie Dai
- Department of Clinical Nutrition, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jin Zhang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Ying Yu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Qian Sun
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Lin-FengYan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yu-Chuan Hu
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Hai-Yan Nan
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Yang Yang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China
| | - Alan D Kaye
- Departments of Anesthesiology and Pharmacology, Louisiana State University School of Medicine, New Orleans, Louisiana, USA
| | - Guang-Bin Cui
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
| | - Wen Wang
- Department of Radiology & Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), 569 Xinsi Road, Xi'an, 710038, Shaanxi, China.
| |
Collapse
|
22
|
Buse DC, Powers SW, Gelfand AA, VanderPluym JH, Fanning KM, Reed ML, Adams AM, Lipton RB. Adolescent Perspectives on the Burden of a Parent's Migraine: Results from the CaMEO Study. Headache 2018; 58:512-524. [DOI: 10.1111/head.13254] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Dawn C. Buse
- Montefiore Medical Center; Bronx NY USA
- Department of Neurology; Albert Einstein College of Medicine; Bronx NY USA
| | - Scott W. Powers
- Headache Center and Division of Behavioral Medicine and Clinical Psychology; Cincinnati Children's Hospital; Cincinnati OH USA
- University of Cincinnati College of Medicine; Cincinnati OH USA
| | - Amy A. Gelfand
- UCSF Pediatric Headache Center and Division of Child Neurology; San Francisco CA USA
| | | | | | | | | | - Richard B. Lipton
- Montefiore Medical Center; Bronx NY USA
- Department of Neurology; Albert Einstein College of Medicine; Bronx NY USA
- Department of Epidemiology and Population Health; Albert Einstein College of Medicine; Bronx NY USA
| |
Collapse
|
23
|
Musil F, Pokladnikova J, Pavelek Z, Wang B, Guan X, Valis M. Acupuncture in migraine prophylaxis in Czech patients: an open-label randomized controlled trial. Neuropsychiatr Dis Treat 2018; 14:1221-1228. [PMID: 29785113 PMCID: PMC5955045 DOI: 10.2147/ndt.s155119] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adjuvant acupuncture for the symptomatic treatment of migraine reduces the frequency of headaches and may be at least similarly effective to treatment with prophylactic drugs. METHODS This article describes an open-label randomized controlled clinical trial with two groups: the intervention group (n=42) and the waiting-list control group (n=44). This study occurred at the Czech-Chinese Center for Traditional Chinese Medicine at the University Hospital Hradec Kralove between October 2015 and April 2017. RESULTS After 12 weeks of acupuncture, the number of migraine days was reduced by 5.5 and 2.0 days in the acupuncture and the waiting-list control groups, respectively, with a statistically significant inter-group difference of 2.0 migraine days (95% CI: -4 to -1). A significantly greater reduction in the number of migraine days per 4 weeks was reached at the end of the 6-month follow-up period in the acupuncture vs. control groups (Δ -4.0; 95% CI: -6 to -2). A statistically significant difference was observed in the number of responders to treatment (response defined as at least a 50% reduction in average monthly migraine day frequency) in the acupuncture vs waiting-list control groups (50% vs 27%; p<0.05) at the end of the intervention. A significantly greater percentage of responders to treatment was noted in the intervention vs control groups at the 6-month follow-up (81% vs 36%; p<0.001). CONCLUSION Acupuncture can reduce symptoms and medication use, both short term and long term, as an adjuvant treatment in migraine prophylaxis in Czech patients.
Collapse
Affiliation(s)
- Frantisek Musil
- Czech-Chinese Center for Traditional Chinese Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jitka Pokladnikova
- Czech-Chinese Center for Traditional Chinese Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Zbysek Pavelek
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Bo Wang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xin Guan
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Martin Valis
- Department of Neurology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| |
Collapse
|
24
|
Silberstein S. AVP-825: a novel intranasal delivery system for low-dose sumatriptan powder in the treatment of acute migraine. Expert Rev Clin Pharmacol 2017; 10:821-832. [DOI: 10.1080/17512433.2017.1339600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
25
|
Lipton RB, Buse DC, Adams AM, Varon SF, Fanning KM, Reed ML. Family Impact of Migraine: Development of the Impact of Migraine on Partners and Adolescent Children (IMPAC) Scale. Headache 2017; 57:570-585. [PMID: 28185239 PMCID: PMC5396278 DOI: 10.1111/head.13028] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/28/2016] [Accepted: 11/29/2016] [Indexed: 11/08/2022]
Abstract
Objective To describe the development of the Impact of Migraine on Partners and Adolescent Children (IMPAC) scale. Background Although existing data and clinical experience suggest that the impact of migraine is pervasive and extends beyond the individual with migraine, no validated tools exist for assessing the impact of migraine on the family. Methods The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study is a longitudinal study of people with migraine in the United States. The Family Burden Module (FBM) of the CaMEO Study contained an item pool of 53 questions derived through literature review, clinician input, and patient focus groups pertaining to the following concepts: impact of migraine on family interpersonal relationships, activities, well‐being, finances, and health‐related quality of life. Respondents with migraine (ie, probands) were categorized into 4 groups based on household composition: migraine probands with partners/spouses and children (M‐PC), migraine probands with partners/spouses only (M‐P), migraine probands with child(ren) only (M‐C), and migraine probands without a partner/spouse or child(ren) (M‐O). The IMPAC scale was developed in 3 steps: (1) exploratory factor analysis and item reduction, (2) bifactor analysis, confirmatory factor analysis, and scoring, and (3) reliability and construct validity analyses. Results The analysis of data from 13,064 respondents to the FBM meeting criteria for migraine yielded a 12‐item IMPAC scale, with 4 items applying to all of the groups, 4 more items applying to the groups with partners (M‐P and M‐PC), and 4 additional items to the groups with children (M‐C and M‐PC). Item responses can be summed and converted into a scoring system assessing mild (<0.5 SD below mean; IMPAC scale Grade I), moderate (0.5 SD below to <0.5 SD above mean; Grade II), severe (0.5‐<1.5 SD above mean; Grade III), and very severe (≥0.5 SD above mean; Grade IV) family impact. Test information curves relating to the IMPAC scale for each household type indicated adequate reliability across a large range of family burden severity (from ∼1 SD below to ∼3 SD above mean) and IMPAC scores showed moderate‐to‐large correlations with other validated tools (range, ± 0.38‐0.52), providing support for construct validity. Conclusions We developed a questionnaire to assess family burden attributed to migraine that is brief, robust, and psychometrically sound, with a simple scoring algorithm that can be applied to various household compositions. This questionnaire may be valuable in research settings to provide quantifiable data on the impact of migraine on family dynamics and in clinical settings to facilitate conversations about family burden as a target and a motivation for better treatment.
Collapse
Affiliation(s)
- Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Medical Center, Bronx, NY, USA
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Medical Center, Bronx, NY, USA
| | | | | | | | | |
Collapse
|
26
|
Fuller-Thomson E, Jayanthikumar J, Agbeyaka SK. Untangling the Association Between Migraine, Pain, and Anxiety: Examining Migraine and Generalized Anxiety Disorders in a Canadian Population Based Study. Headache 2016; 57:375-390. [PMID: 27991658 DOI: 10.1111/head.13010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/29/2016] [Accepted: 10/30/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aims of this study were to investigate: (1) the prevalence and unadjusted and adjusted odds of 12-month generalized anxiety disorder (GAD) among adults with migraine in comparison to those without migraine; (2) If debilitating pain and/or limitations in instrumental activities of daily living (IADLs) are mediators of the migraine-GAD association; and (3) Factors associated with past year GAD among adults with migraine. METHODS Secondary data analysis of the nationally representative 2012 Canadian Community Health Survey-Mental Health (CCHS-MS), a population-based survey of community dwellers with a response rate of 68.9%. The first subsample included those with (n = 2232) and without migraine (n = 19,270), and the second subsample was restricted to those with migraine (n = 2232). GAD was based on the WHO-CIDI scale. RESULTS Fully, 6% of those with migraines had past year GAD in comparison of 2.1% of those without migraine (P < .001). The socio-demographically adjusted odds of past year GAD were two and a half times higher among those with migraine than those without (OR= 2.46; 95% CI = 2.00, 3.02). A path analysis indicated that debilitating pain and limitations in IADLs were mediators in the relationship between migraine and GAD. In the sample restricted to migraineurs, the factors associated with higher odds of 12-month GAD included having a university degree, having low income, being without a confidant, and being male. CONCLUSIONS Generalized anxiety disorder is robustly associated with migraine and targeted outreach and interventions are warranted.
Collapse
Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Janany Jayanthikumar
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Senyo K Agbeyaka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
27
|
Buse DC, Scher AI, Dodick DW, Reed ML, Fanning KM, Manack Adams A, Lipton RB. Impact of Migraine on the Family: Perspectives of People With Migraine and Their Spouse/Domestic Partner in the CaMEO Study. Mayo Clin Proc 2016; 91:S0025-6196(16)00126-9. [PMID: 27132088 DOI: 10.1016/j.mayocp.2016.02.013] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the impact of migraine on family members, activities, and relationships from the perspectives of the person with migraine and his or her spouse/domestic partner. PATIENTS AND METHODS The Chronic Migraine Epidemiology and Outcomes (CaMEO) study is a longitudinal, Web-based study conducted from September 2012 to November 2013. Quota sampling from an online panel identified respondents who met modified International Classification of Headache Disorders, version 3 beta migraine criteria. The Family Burden Module included 24 items covering 6 domains. Findings for respondents with episodic migraine (EM) and chronic migraine (CM) are presented for both the affected individuals and their partners. RESULTS Among 13,064 Family Burden Module respondents (65.7% response rate), there were 4022 migraineur-spouse dyads, including 2275 dyads with children. Burden increased with headache frequency across all 6 domains. People with migraine reported higher family burden due to migraine than did their spouse/partner. Reduced participation in family activities due to migraine was reported 1 or more times a month among 48.2% to 57.4% of migraineurs, depending on headache frequency (days/month). Many (low-frequency to high-frequency EM, 24.4%-40.4%; CM, 43.9%) perceived that their spouse/partner did not believe the severity/impact of their headaches. One-third of migraineurs stated that they worried about long-term financial security for themselves or their family because of their headaches. Many migraineurs felt they would be better parents without headaches (low-frequency to high-frequency EM, 29.9%-58.0%; CM, 71.7%). CONCLUSION This analysis quantified the pervasive burden of migraine on the family, highlighting the impact on family activities and relationships. Not surprisingly, the impact was greatest in families of people with CM.
Collapse
Affiliation(s)
- Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY.
| | - Ann I Scher
- Department of Preventive Medicine & Biometrics, Affiliated with Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | | | | | | | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY
| |
Collapse
|
28
|
Frisk P, Sporrong SK, Ljunggren G, Wettermark B, von Euler M. Utilisation of prescription and over-the-counter triptans: a cross-sectional study in Stockholm, Sweden. Eur J Clin Pharmacol 2016; 72:747-54. [PMID: 26922586 DOI: 10.1007/s00228-016-2028-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 02/15/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Triptans are widely used in acute migraine, and in some countries, they are also available over-the-counter (OTC). In Sweden, sales have increased for both prescription and OTC triptans. This study aimed to describe current prescribing and utilisation patterns of prescription and OTC triptans in Stockholm, Sweden. METHODS Register data from 4759 patients dispensed triptans in 2014 were used to study documented diagnosis of migraine, concomitant acute and preventive treatment for migraine, and contraindications. Survey data from 49 patients purchasing OTC triptans in three pharmacies were used to capture physician-diagnosed migraine, concomitant acute and preventive treatment for migraine, a behaviour of combining or alternating between prescription and OTC triptans, and pharmacy counselling rates. RESULTS Among the prescription triptan users, 52 % had a recorded diagnosis of migraine, 48 % had no other acute treatment, preventive treatment was rare (12 %) and contraindications were found in 2 % of the patients. Among the OTC triptan users, the majority (63 %) had been diagnosed by a physician and had a history of prescription triptan use, but combining or alternating between OTC and prescription triptans was rare. Concomitant acute treatment was reported in 53 % and preventive treatment was rare (4 %), despite high self-reported migraine frequencies. Some off-label use was detected, despite moderate to high counselling rates. CONCLUSION Triptans are prescribed with attention to safety but with poor recording of migraine diagnosis. OTC triptan users generally have a history of prescription triptan use. Preventive treatment rates are low in both groups. Strategies to discern patients who need other treatment options should be considered.
Collapse
Affiliation(s)
- Pia Frisk
- Department of Pharmaceutical Biosciences, Uppsala university, Box 591, Uppsala, SE-751 24, Sweden. .,Department of Healthcare development, Public Healthcare Services Committee, Stockholm County Council, Box 6909, Stockholm, SE-102 39, Sweden.
| | - Sofia K Sporrong
- Department of Pharmacy, Section for Social and Clinical Pharmacy, University of Copenhagen, Universitetsparken 2, Copenhagen, DK-2100, Denmark
| | - Gunnar Ljunggren
- Department of Healthcare development, Public Healthcare Services Committee, Stockholm County Council, Box 6909, Stockholm, SE-102 39, Sweden.,Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Berzelius väg 3, Stockholm, SE-171 77, Sweden
| | - Björn Wettermark
- Department of Healthcare development, Public Healthcare Services Committee, Stockholm County Council, Box 6909, Stockholm, SE-102 39, Sweden.,Clinical Pharmacology and Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Clinical Epidemiology Unit T2, Karolinska University Hospital, Solna, Stockholm, SE-171 76, Sweden
| | - Mia von Euler
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, Stockholm, SE-118 83, Sweden.,Department of Clinical Pharmacology L7:03, Karolinska University Hospital, Solna, SE-171 76, Sweden
| |
Collapse
|
29
|
González-Quintanilla V, Toriello M, Palacio E, González-Gay MA, Castillo J, Montes S, Martínez-Nieto R, Fernandez J, Rojo A, Gutiérrez S, Pons E, Oterino A. Systemic and cerebral endothelial dysfunction in chronic migraine. A case-control study with an active comparator. Cephalalgia 2015; 36:552-60. [PMID: 26395894 DOI: 10.1177/0333102415607857] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 08/30/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Unlike migraine and migraine with aura, little information exists regarding chronic migraine (CM) as a risk factor for cardiovascular disease. In this study we aim to determine whether an association between CM and endothelial dysfunction exists. METHODS Individuals 18 years and older diagnosed with episodic migraine (EM) and CM according to ICHD criteria were studied. After an overnight fast and abstinence from vasoactive drugs, ultrasound studies were performed and blood samples taken from patients and matched controls according to internationally agreed on protocols. RESULTS A total of 113 individuals were enrolled (35 CM, 37 EM, 41 controls). CM patients had a lower percentage of flow-mediated vasodilation (FMD; difference of means = 5.03%; p = 1.0E-6) and breath-holding index (BHI; difference of means 0.754; p = 2.0E-6), as well as increased carotid intima media thickness (cIMT; difference of means = 0.128 mm; p = 7.0E-5) than controls. The EM patients and controls comparison found similar, but less pronounced, differences: decreased BHI (p = 0.031), and increased cIMT (p = 0.028). Fibrinogen (r = 0.277; p = 0.006), C-reactive protein (r = 0.288; p = 0.003), and erythrocyte rate sedimentation (r = 0.298; p = 0.002) also correlated with cIMT, and inversely with BHImV and FMD. CONCLUSIONS Migraine is associated with systemic and cerebral endothelial dysfunction demonstrated by ultrasound studies and biological markers. The degree of these changes was strongly associated with the severity of migraine. Our data indicate that migraine may be a cerebral disorder with systemic endothelial damage.
Collapse
Affiliation(s)
| | - María Toriello
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Enrique Palacio
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Miguel A González-Gay
- Service of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Jesús Castillo
- Health Service of Camargo Costa, Servicio Cántabro de Salud, Spain
| | - Silvia Montes
- Health Service of Camargo Costa, Servicio Cántabro de Salud, Spain
| | | | - Jenifer Fernandez
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Alvaro Rojo
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Silvia Gutiérrez
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Enar Pons
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| | - Agustín Oterino
- Service of Neurology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Spain
| |
Collapse
|
30
|
Brennenstuhl S, Fuller-Thomson E. The Painful Legacy of Childhood Violence: Migraine Headaches Among Adult Survivors of Adverse Childhood Experiences. Headache 2015; 55:973-83. [PMID: 26104222 DOI: 10.1111/head.12614] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood adversities have been associated with adult migraine in the general population. However, most research has focused on only a few types of maltreatment and has not always controlled for factors correlated with early adversities and migraine. OBJECTIVES The aim of this study was to investigate the relationship between early adversities and migraine, while controlling for a range of potential explanatory factors. METHODS We analyzed data from the 2012 Canadian Community Health Survey - Mental Health. Using a representative sample of 10,358 men and 12,638 women, we undertook gender-specific logistic regression analyses to determine the association between number and type of self-reported childhood adversities (physical abuse, sexual abuse, and witnessing parental domestic violence) and migraine, while controlling for sociodemographics, comorbid adversities, health behaviors, depression, and anxiety. RESULTS In total, 6.5% of men and 14.2% of women reported migraines. All three adversities were significantly associated with migraine for both genders, even after controlling for a range of variables. The fully adjusted odds of migraine associated with physical abuse, parental domestic violence, and sexual abuse were 1.61 (95% confidence interval [CI] = 1.42-1.83), 1.64 (95% CI = 1.39-1.93), and 1.32 (95% CI = 1.11-1.57), respectively, for women, and 1.50 (95% CI = 1.25-1.80), 1.52 (95% CI = 1.16-1.98), and 1.70 (95% CI = 1.22-2.36) for men. Greater number of adversities was also associated with increasing odds of migraine. Men reporting all three adversities had over three times (odds ratio = 3.26; 95% CI = 2.09-5.07) and women over two times (OR = 2.85; 95% CI = 2.25-3.60) the odds of migraine compared with those without childhood adversities. CONCLUSIONS Number and type of early adversities are associated with migraine among Canadian men and women.
Collapse
Affiliation(s)
- Sarah Brennenstuhl
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| |
Collapse
|
31
|
Li K, Zhang Y, Ning Y, Zhang H, Liu H, Fu C, Ren Y, Zou Y. The effects of acupuncture treatment on the right frontoparietal network in migraine without aura patients. J Headache Pain 2015; 16:518. [PMID: 25916336 PMCID: PMC4411327 DOI: 10.1186/s10194-015-0518-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 04/14/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Functional and structural abnormalities in resting-state brain networks in migraine patients have been confirmed by previous functional magnetic resonance imaging (fMRI) studies. However, few studies focusing on the neural responses of therapeutic treatment on migraine have been conducted. In this study, we tried to examined the treatment-related effects of standard acupuncture treatment on the right frontoparietal network (RFPN) in migraine patients. METHODS A total of 12 migraine without aura (MWoA) patients were recruited to undergo resting-state fMRI scanning and were rescanned after 4 weeks standard acupuncture treatment. Another 12 matched healthy control (HC) subjects underwent once scanning for comparison. We analyzed the functional connectivity of the RFPN between MWoA patients and HC subjects before treatment and that of the MWoA patients before and after treatment. Diffusion tensor images (DTI) data analyzing was also performed to detect fiber-related treatment responses. RESULTS We observed significantly decreased FC in the RFPN and that the decreased FC could be reversed by acupuncture treatment. The changes of FC in MWoA patients was negatively correlated with the decrease of visual analogue scale (VAS) scores after treatment. This study indicated that acupuncture treatment for MWoA patients was associated with normalizing effects on the intrinsic decreased FC of the RFPN. CONCLUSIONS Our study provided new insights into the treatment-related neural responses in MWoA patients and suggested potential functional pathways for the evaluation of treatment in MWoA patients. Future studies are still in need to confirm the current results and to elucidate the complex neural mechanisms of acupuncture treatment.
Collapse
Affiliation(s)
- Kuangshi Li
- Department of Neurology and Stroke Center, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China,
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Zhang Y, Li KS, Liu HW, Fu CH, Chen S, Tan ZJ, Ren Y. Acupuncture treatment modulates the resting-state functional connectivity of brain regions in migraine patients without aura. Chin J Integr Med 2015; 22:293-301. [PMID: 25847772 DOI: 10.1007/s11655-015-2042-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the modulatory effect of acupuncture treatment on the resting-state functional connectivity of brain regions in migraine without aura (MWoA) patients. METHODS Twelve MWoA patients were treated with standard acupuncture treatment for 4 weeks. All MWoA patients received resting-state functional magnetic resonance imaging (fMRI) scanning before and after acupuncture treatment. Another 12 normal subjects matched in age and gender were recruited to serve as healthy controls. The changes of restingstate functional connectivity in MWoA patients before and after the acupuncture treatment and those with the healthy controls were compared. RESULTS Before acupuncture treatment, the MWoA patients had significantly decreased functional connectivity in certain brain regions within the frontal and temporal lobe when compared with the healthy controls. After acupuncture treatment, brain regions showing decreased functional connectivity revealed significant reduction in MWoA patients compared with before acupuncture treatment. CONCLUSIONS Acupuncture treatment could increase the functional connectivity of brain regions in the intrinsic decreased brain networks in MWoA patients. The results provided further insights into the interpretation of neural mechanisms of acupuncture treatment for migraine.
Collapse
Affiliation(s)
- Yong Zhang
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Kuang-shi Li
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Hong-wei Liu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Cai-hong Fu
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Sheng Chen
- Department of Acupuncture, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Zhong-jian Tan
- Department of Magnetic Resonance Imaging, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yi Ren
- Department of Neurology and Stroke Center, Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, 100700, China.
| |
Collapse
|
33
|
Bhambri R, Mardekian J, Liu LZ, Schweizer E, Ramos E. A review of the pharmacoeconomics of eletriptan for the acute treatment of migraine. Int J Gen Med 2015; 8:27-36. [PMID: 25624770 PMCID: PMC4296958 DOI: 10.2147/ijgm.s73673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Migraine is a commonly occurring, chronic disorder that can cause significant disability. Eletriptan, a selective serotonin 5-hydroxytryptamine 1 receptor subtype B/D (5-HT1B/1D) agonist, is a clinically effective treatment for moderate to severe migraine. The objective of this literature review was to summarize the available data on the pharmacoeconomics of eletriptan relative to other triptans. Articles meeting the following three criteria were included in the review: 1) contained pharmacoeconomic data on a marketed dose of eletriptan; 2) included data on at least one other comparator triptan; and 3) was in English. A MEDLINE® search yielded a total of eight studies (from the European Union [n=5] and from the USA [n=3]) across multiple regions. Seven of the studies examined the pharmacoeconomics of eletriptan relative to other triptans, and a further study examined the health care costs of eletriptan 40 mg versus sumatriptan 100 mg. Eletriptan 40 mg was among a group of triptans, including rizatriptan 10 mg and almotriptan 12.5 mg, demonstrating the greatest cost-effectiveness. This result held across different definitions of efficacy (2 hours pain-free, sustained pain-free, and sustained pain-free with no adverse events) and also held when cost-effectiveness models accounted for second doses and use of rescue medication, management of adverse events, and productivity loss, in addition to drug acquisition costs. Only limited head-to-head comparator data were available. The majority of pharmacoeconomic studies utilized the same set of efficacy and/or tolerability data, and indirect costs were rarely included despite the fact that the majority of per capita migraine costs are attributable to indirect costs. In summary, although the market is now dominated by generics, eletriptan 40 mg is among the most clinically and cost-effective oral triptans available for the management of acute migraine. Increased effectiveness/efficacy of eletriptan may necessitate a lesser need for other migraine treatments and/or switching to other triptans.
Collapse
Affiliation(s)
| | | | - Larry Z Liu
- Pfizer, Inc., New York, NY, USA ; Weill Medical College of Cornell University, New York, NY, USA
| | | | | |
Collapse
|
34
|
Whitcup SM, Turkel CC, DeGryse RE, Brin MF. Development of onabotulinumtoxinA for chronic migraine. Ann N Y Acad Sci 2014; 1329:67-80. [DOI: 10.1111/nyas.12488] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | | | | | - Mitchell F. Brin
- Allergan, Inc Irvine California
- Department of Neurology University of California Irvine California
| |
Collapse
|
35
|
Zhao L, Liu J, Zhang F, Dong X, Peng Y, Qin W, Wu F, Li Y, Yuan K, von Deneen KM, Gong Q, Tang Z, Liang F. Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: a randomized controlled trial on active acupoints and inactive acupoints. PLoS One 2014; 9:e99538. [PMID: 24915066 PMCID: PMC4051855 DOI: 10.1371/journal.pone.0099538] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 05/14/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acupuncture has been commonly used for preventing migraine attacks and relieving pain during a migraine, although there is limited knowledge on the physiological mechanism behind this method. The objectives of this study were to compare the differences in brain activities evoked by active acupoints and inactive acupoints and to investigate the possible correlation between clinical variables and brain responses. METHODS AND RESULTS A randomized controlled trial and resting-state functional magnetic resonance imaging (fMRI) were conducted. A total of eighty migraineurs without aura were enrolled to receive either active acupoint acupuncture or inactive acupoint acupuncture treatment for 8 weeks, and twenty patients in each group were randomly selected for the fMRI scan at the end of baseline and at the end of treatment. The neuroimaging data indicated that long-term active acupoint therapy elicited a more extensive and remarkable cerebral response compared with acupuncture at inactive acupoints. Most of the regions were involved in the pain matrix, lateral pain system, medial pain system, default mode network, and cognitive components of pain processing. Correlation analysis showed that the decrease in the visual analogue scale (VAS) was significantly related to the increased average Regional homogeneity (ReHo) values in the anterior cingulate cortex in the two groups. Moreover, the decrease in the VAS was associated with increased average ReHo values in the insula which could be detected in the active acupoint group. CONCLUSIONS Long-term active acupoint therapy and inactive acupoint therapy have different brain activities. We postulate that acupuncture at the active acupoint might have the potential effect of regulating some disease-affected key regions and the pain circuitry for migraine, and promote establishing psychophysical pain homeostasis. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-TRC-13003635.
Collapse
Affiliation(s)
- Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jixin Liu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
- * E-mail: (FL), (JL)
| | - Fuwen Zhang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xilin Dong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yulin Peng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Qin
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Fumei Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Karen M. von Deneen
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Qiyong Gong
- Department of Radiology, The Center for Medical Imaging, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zili Tang
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- * E-mail: (FL), (JL)
| |
Collapse
|
36
|
|
37
|
Migraine and Despair: Factors Associated with Depression and Suicidal Ideation among Canadian Migraineurs in a Population-Based Study. DEPRESSION RESEARCH AND TREATMENT 2013; 2013:401487. [PMID: 24224086 PMCID: PMC3810321 DOI: 10.1155/2013/401487] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/30/2013] [Accepted: 09/04/2013] [Indexed: 11/17/2022]
Abstract
This study sought to (1) investigate the association between migraine and both depression and suicidal ideation and (2) to identify the factors independently associated with each of these mental health problems among Canadian men and women with migraine. Data were analyzed from the 2005 Canadian Community Health Survey (CCHS). Presence of migraine was assessed by self-report of a health professional diagnosis. Current depression was measured using the CIDI-SF, and suicidal ideation was based on a question about serious consideration of suicide at any point during the respondent's lifetime. Migraineurs were found to have elevated odds of depression (men: OR = 2.02; 95% CI = 1.70, 2.41; women: OR = 1.89; 95% CI = 1.71, 2.10) and suicidal ideation (men: OR = 1.70; 95% CI = 1.55, 1.96; women: OR = 1.72; 95% CI = 1.59, 1.86) even when adjusting for sociodemographic variables and disability status. The odds of depression and suicidal ideation were higher among both genders of migraineurs who were younger, unmarried and had more activity limitations; associations with poverty and race depended on gender and whether the focus was on depression or suicidal ideation. While screening for depression is already recommended for those with migraine, this research helps identify which migraineurs may require more immediate attention, including those who are younger, unmarried, and experiencing limitations in their activities.
Collapse
|