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Tudela‐Tomas J, Ramos‐Guerrero R, Rodriguez‐Mateos M. Reversion of chronic to episodic migraine in working age and botulinum toxin-resistant patients treated with fremanezumab: A real-life study. Brain Behav 2024; 14:e3631. [PMID: 39034358 PMCID: PMC11260548 DOI: 10.1002/brb3.3631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 05/01/2024] [Accepted: 07/03/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVES The objectives of this real-life study were to analyze the reversion of chronic migraine (CM) to episodic migraine (EM) with fremanezumab, evaluate its benefit on the symptomatology, and determine the influence of possible clinical features on the reversion. BACKGROUND The clinical manifestations of CM have a high impact on the quality of life of patients, and monoclonal antibodies such as fremanezumab are used as prophylactic treatment. METHODS Diagnosed CM patients treated for at least 3 months with monthly fremanezumab were interviewed. The data to assess efficacy were before treatment and at the time of the interview: monthly headache days (MHDs), daily headache hours (DHHs), monthly symptomatic medication days (MSMDs), percentage of patients with symptomatic medication overuse (SMO), and pain intensity with the numerical rating scale (NRS) score. Possible predictors of reversion were analyzed: percentage of patients treated for at least 12 months, hypertension, diabetes mellitus, depression, anxiety, symptomatic control with non-steroidal anti-inflammatory drugs (NSAIDs), triptans or both, and amitriptyline prophylaxis. RESULTS A total of 54 patients were included, of whom 40 (74.1%) were converters to EM. There were significant improvements in converters compared to pre-treatment in MHDs (28.0 vs. 5.0 days), as well as on the variables DHHs, MSMDs, and SMO. The percentage of erenumab failures was significantly higher in non-converters than in converters, as was the percentage of patients with anxiety. CONCLUSIONS High reversion from CM to EM was achieved with fremanezumab and notable symptomatological improvement, establishing previous failure to erenumab and anxiety as possible detrimental factors for reversion.
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Affiliation(s)
- Juan Tudela‐Tomas
- Servicio de Farmacia HospitalariaHospital Universitario Puerta del MarCadizSpain
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Wu J, Fang J, Yuan X, Ma L, Zheng L, Lin Q, An X, Wang Z, Ma Q. Associations of type 2 diabetes and the risk of migraine in Chinese populations. DIABETES & METABOLISM 2024; 50:101518. [PMID: 38272255 DOI: 10.1016/j.diabet.2024.101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/27/2024]
Abstract
AIM We aimed to explore the relationship between type 2 diabetes mellitus (T2DM) and the incidence rate of migraine in a Chinese population, and analyze the clinical characteristics of migraine patients with T2DM. METHODS Data on the study cohort of 9873 individuals were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The incidence rate of migraine from 2015 to 2018 was assessed. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for the relationship between T2DM and the incidence of migraine. In addition, a cross-sectional study including 168 migraine patients was conducted in Xiamen, China. Migraine patients were grouped according to their T2DM status. Multivariable linear regression models were used to estimate βs and their 95% CIs for the relationship between migraine characteristics and T2DM. RESULTS The cumulative incidence rate of migraine from 2015 to 2018 in the T2DM group and control group was 7.26% [6.04%.8.65%] and 8.91% [8.27%.9.58%], respectively. The risk of migraine in patients with T2DM was reduced by 21% (HR 0.79 [0.65;0.95]) compared to patients with no T2DM after adjustment for confounders. The cross-sectional study showed that the presence of T2DM significantly reduced migraine frequency and relieved migraine intensity. CONCLUSION This was the first study to validate that T2DM reduced the risk of migraine in a Chinese population cohort. Patients with migraine and T2DM may experience significant relief from their headache symptoms. Carrying out relevant mechanistic research may help to identify new targets for migraine treatment and contribute to further understanding the impact of T2DM or related metabolic disorders on an individual's health.
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Affiliation(s)
- Jielong Wu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; School of Medicine, Xiamen University, China; National Institute for Data Science in Health and Medicine, Xiamen University, China
| | - Jie Fang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; The School of Clinical Medicine, Fujian Medical University, China; Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China
| | - Xiaodong Yuan
- Department of Gynecology of Xiamen Maternal and Child Health Care Hospital, China
| | - Lingshan Ma
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; School of Medicine, Xiamen University, China; National Institute for Data Science in Health and Medicine, Xiamen University, China
| | - Liangcheng Zheng
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; The School of Clinical Medicine, Fujian Medical University, China; Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China
| | - Qing Lin
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; The School of Clinical Medicine, Fujian Medical University, China; Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China
| | - Xingkai An
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; The School of Clinical Medicine, Fujian Medical University, China; Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China
| | - Zhanxiang Wang
- Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China; School of Medicine, Xiamen University, China; National Institute for Data Science in Health and Medicine, Xiamen University, China; Department of Neurosurgery and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Qilin Ma
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; The School of Clinical Medicine, Fujian Medical University, China; Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, China; Xiamen Key Laboratory of Brain Center, China; Xiamen Medical Quality Control Center for Neurology, China; Fujian Provincial Clinical Research Center for Brain Diseases, China; Xiamen Clinical Research Center for Neurological Diseases, China; School of Medicine, Xiamen University, China; National Institute for Data Science in Health and Medicine, Xiamen University, China.
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Di Lauro M, Guerriero C, Cornali K, Albanese M, Costacurta M, Mercuri NB, Di Daniele N, Noce A. Linking Migraine to Gut Dysbiosis and Chronic Non-Communicable Diseases. Nutrients 2023; 15:4327. [PMID: 37892403 PMCID: PMC10609600 DOI: 10.3390/nu15204327] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
In the world, migraine is one of the most common causes of disability in adults. To date, there is no a single cause for this disorder, but rather a set of physio-pathogenic triggers in combination with a genetic predisposition. Among the factors related to migraine onset, a crucial role seems to be played by gut dysbiosis. In fact, it has been demonstrated how the intestine is able to modulate the central nervous system activities, through the gut-brain axis, and how gut dysbiosis can influence neurological pathologies, including migraine attacks. In this context, in addition to conventional pharmacological treatments for migraine, attention has been paid to an adjuvant therapeutic strategy based on different nutritional approaches and lifestyle changes able to positively modulate the gut microbiota composition. In fact, the restoration of the balance between the different gut bacterial species, the reconstruction of the gut barrier integrity, and the control of the release of gut-derived inflammatory neuropeptides, obtained through specific nutritional patterns and lifestyle changes, represent a possible beneficial additive therapy for many migraine subtypes. Herein, this review explores the bi-directional correlation between migraine and the main chronic non-communicable diseases, such as diabetes mellitus, arterial hypertension, obesity, cancer, and chronic kidney diseases, whose link is represented by gut dysbiosis.
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Affiliation(s)
- Manuela Di Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Cristina Guerriero
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Kevin Cornali
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
| | - Maria Albanese
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Neurology Unit, Headache Center, Tor Vergata University Hospital, 00133 Rome, RM, Italy
| | - Micaela Costacurta
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, RM, Italy;
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Neurology Unit, Headache Center, Tor Vergata University Hospital, 00133 Rome, RM, Italy
| | - Nicola Di Daniele
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- Fondazione Leonardo per le Scienze Mediche Onlus, Policlinico Abano, 35031 Abano Terme, PD, Italy
| | - Annalisa Noce
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, RM, Italy; (M.D.L.); (C.G.); (K.C.); (M.A.); (N.B.M.); (N.D.D.)
- UOSD Nephrology and Dialysis, Policlinico Tor Vergata, 00133 Rome, RM, Italy
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Islam MR, Nyholt DR. Cross-trait analyses identify shared genetics between migraine, headache, and glycemic traits, and a causal relationship with fasting proinsulin. Hum Genet 2023; 142:1149-1172. [PMID: 36808568 PMCID: PMC10449981 DOI: 10.1007/s00439-023-02532-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
The co-occurrence of migraine and glycemic traits has long been reported in observational epidemiological studies, but it has remained unknown how they are linked genetically. We used large-scale GWAS summary statistics on migraine, headache, and nine glycemic traits in European populations to perform cross-trait analyses to estimate genetic correlation, identify shared genomic regions, loci, genes, and pathways, and test for causal relationships. Out of the nine glycemic traits, significant genetic correlation was observed for fasting insulin (FI) and glycated haemoglobin (HbA1c) with both migraine and headache, while 2-h glucose was genetically correlated only with migraine. Among 1703 linkage disequilibrium (LD) independent regions of the genome, we found pleiotropic regions between migraine and FI, fasting glucose (FG), and HbA1c, and pleiotropic regions between headache and glucose, FI, HbA1c, and fasting proinsulin. Cross-trait GWAS meta-analysis with glycemic traits, identified six novel genome-wide significant lead SNPs with migraine, and six novel lead SNPs with headache (Pmeta < 5.0 × 10-8 and Psingle-trait < 1 × 10-4), all of which were LD-independent. Genes with a nominal gene-based association (Pgene ≤ 0.05) were significantly enriched (overlapping) across the migraine, headache, and glycemic traits. Mendelian randomisation analyses produced intriguing, but inconsistent, evidence for a causal relationship between migraine and headache with multiple glycemic traits; and consistent evidence suggesting increased fasting proinsulin levels may causally decrease the risk of headache. Our findings indicate that migraine, headache, and glycemic traits share a common genetic etiology and provide genetic insights into the molecular mechanisms contributing to their comorbid relationship.
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Affiliation(s)
- Md Rafiqul Islam
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, School of Biomedical Sciences, Faculty of Health and Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia.
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Salahi M, Parsa S, Nourmohammadi D, Razmkhah Z, Salimi O, Rahmani M, Zivary S, Askarzadeh M, Tapak MA, Vaezi A, Sadeghsalehi H, Yaghoobpoor S, Mottahedi M, Garousi S, Deravi N. Immunologic aspects of migraine: A review of literature. Front Neurol 2022; 13:944791. [PMID: 36247795 PMCID: PMC9554313 DOI: 10.3389/fneur.2022.944791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Migraine headaches are highly prevalent, affecting 15% of the population. However, despite many studies to determine this disease's mechanism and efficient management, its pathophysiology has not been fully elucidated. There are suggested hypotheses about the possible mediating role of mast cells, immunoglobulin E, histamine, and cytokines in this disease. A higher incidence of this disease in allergic and asthma patients, reported by several studies, indicates the possible role of brain mast cells located around the brain vessels in this disease. The mast cells are more specifically within the dura and can affect the trigeminal nerve and cervical or sphenopalatine ganglion, triggering the secretion of substances that cause migraine. Neuropeptides such as calcitonin gene-related peptide (CGRP), neurokinin-A, neurotensin (NT), pituitary adenylate-cyclase-activating peptide (PACAP), and substance P (SP) trigger mast cells, and in response, they secrete pro-inflammatory and vasodilatory molecules such as interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) as a selective result of corticotropin-releasing hormone (CRH) secretion. This stress hormone contributes to migraine or intensifies it. Blocking these pathways using immunologic agents such as CGRP antibody, anti-CGRP receptor antibody, and interleukin-1 beta (IL-1β)/interleukin 1 receptor type 1 (IL-1R1) axis-related agents may be promising as potential prophylactic migraine treatments. This review is going to summarize the immunological aspects of migraine.
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Affiliation(s)
- Mehrnaz Salahi
- Student Research Committee, School of Pharmacy and Pharmaceutical Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sina Parsa
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Delaram Nourmohammadi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Razmkhah
- Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Salimi
- Student Research Committee, Faculty of Medicine, Islamic Azad University of Najafabad, Isfahan, Iran
| | | | - Saeid Zivary
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Monireh Askarzadeh
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Tapak
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Vaezi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Sadeghsalehi
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shirin Yaghoobpoor
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Mottahedi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Setareh Garousi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Investigation of the correlation between diabetic retinopathy and prevalent and incident migraine in a national cohort study. Sci Rep 2022; 12:12443. [PMID: 35859157 PMCID: PMC9300720 DOI: 10.1038/s41598-022-16793-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 07/15/2022] [Indexed: 11/21/2022] Open
Abstract
Migraine is a disease characterized by cerebral vasodilation. While diabetes has previously been associated with a lower risk of migraine, it is not known if diabetic retinopathy (DR), a retinal peripheral vascular occlusive disease, is a potential biomarker of protection against migraine. Therefore, we aimed to examine diabetic retinopathy as a marker of prevalent and 5-year incident migraine. In a national cohort, we compared patients with diabetes attending DR screening from The Danish National Registry of Diabetic Retinopathy (cases, n = 205,970) to an age- and gender-matched group of patients without diabetes (controls, n = 1,003,170). In the cross-sectional study, a multivariable model demonstrated a lower prevalence of migraine among cases compared with controls (OR 0.83, 95% CI 0.81–0.85), with a lower risk in cases with DR than in those without (OR 0.69, 95% CI 0.65–0.72). In the prospective study, a lower risk of incident migraine was found in a multivariable model in cases (HR 0.76, 95% CI 0.70–0.82), but this did not depend upon the presence of DR. To conclude, in a national study of more than 1.2 million people, patients screened for DR had a lower risk of present migraine, but DR was not a protective marker of incident migraine.
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Fortini I, Felsenfeld BD. Headaches and obesity. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:204-213. [PMID: 35976296 PMCID: PMC9491411 DOI: 10.1590/0004-282x-anp-2022-s106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Obesity and headache disorders are two very common conditions in the general population that have been increasing in incidence over the last decades. Recent studies have shown a significant relationship between obesity and headaches, particularly migraine, with an important role in whether the disease is chronic. On the other hand, no such association was found with tension-type headaches. Studies showing an overlapping of hunger-control pathways and those involved in the pathophysiology of migraine may justify the close association between obesity and migraine. Moreover, a secondary headache for which obesity is a strong risk factor is idiopathic Intracranial Hypertension (pseudotumor cerebri), with several studies showing the impact of weight reduction/bariatric surgery in the treatment of the disease. In conclusion, since obesity is a modifiable risk factor, it is important for physicians treating patients with headaches, and particularly migraine, to be aware of the association between these two disorders.
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Affiliation(s)
- Ida Fortini
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil
| | - Bernardo Dror Felsenfeld
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil
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Glucose-Related Traits and Risk of Migraine—A Potential Mechanism and Treatment Consideration. Genes (Basel) 2022; 13:genes13050730. [PMID: 35627115 PMCID: PMC9141901 DOI: 10.3390/genes13050730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 12/16/2022] Open
Abstract
Migraine and glucose-related (glycaemic) traits (fasting glucose, fasting insulin, and type 2 diabetes) are common and complex comorbid disorders that cause major economic and social burdens on patients and their families. Studies on the relationship between migraine and glucose-related traits have yielded inconsistent results. The purpose of this review is to synthesise and discuss the information from the available literature on the relationship between fasting glucose, fasting insulin, and type 2 diabetes (T2D) with migraine. Publications on migraine and fasting glucose, migraine and fasting insulin, and migraine and T2D were identified from a PubMed and Google Scholar database search and reviewed for this article. Multiple publications have suggested that the comorbidity of migraine and glucose-related traits may have a similar complex pathogenic mechanism, including impaired glucose homeostasis, insulin resistance, reduced cerebrovascular reactivity, abnormal brain metabolism, shared genetic factors, neurotransmitters, and sex hormones. Furthermore, several studies have found a bi-directional link between migraine with insulin resistance and T2D. There is strong evidence for a biological association between migraine headache and glucose-related traits, and burgeoning evidence for shared genetic influences. Therefore, genetic research into these comorbid traits has the potential to identify new biomarkers and therapeutic targets and provide biological insight into their relationships. We encourage healthcare professionals to consider the co-occurrence of migraine with glucose-related traits in the evaluation and treatment of their patients.
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Fanaeian MM, Alibeik N, Ganji A, Fakheri H, Ekhlasi G, Shahbazkhani B. Prevalence of migraine in adults with celiac disease: A case control cross-sectional study. PLoS One 2021; 16:e0259502. [PMID: 34788304 PMCID: PMC8598245 DOI: 10.1371/journal.pone.0259502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/20/2021] [Indexed: 01/02/2023] Open
Abstract
AIM Celiac disease (CD) is an immune-mediated disorder with various manifestations. The aim of this study was to evaluate the prevalence of gastrointestinal (GI) and extra-intestinal symptoms of celiac patients, especially migraine, and compare it with healthy individuals. METHODS We compared 1000 celiac subjects (CS) registered at our celiac center with the control group for headache-based on International Classification of Headache Disorders, third edition criteria and their GI symptoms. Besides, CS with migraine and non-migrainous headache were compared in terms of GI symptoms and accompanied conditions. RESULTS Headache was more common in CS than controls (34% vs 27% respectively, P value<0.001) and more prevalent in females (71.9% in females vs 28% in males, P value = 0.004). Moreover, the prevalence of migraine in CS was higher than controls (20.7 vs 11.9% respectively, P value<0.001). Furthermore, migraine was more prevalent in females with CD (80% in females vs 19% in males, P value = 0.033), and often without aura (76%). Abdominal pain (76.9%, P value = 0.025), diarrhea (54.9%, P value = 0.002), and constipation (42.9%, P value = 0.011) were the most common GI symptoms in CS with headache and more prevalent in CS with migraine. Conversely, type 1 diabetes mellitus was less common in CS with migraine than in CS with non-migrainous headache. (P value = 0.001). On multivariate logistic regression analysis, female sex (OR 1.50, 95%CI 1.22-1.83, P value < 0.001), and CD (OR 1.36, 95%CI 1.12-1.65, P value = 0.002) were independent predictors of headache, whereas age more than 60 years (OR 0.70, 95%CI 0.50-0.97, P value = 0.032) had a protective effect. CONCLUSION Headache especially migraine is more prevalent in CS than healthy controls. In addition, abdominal pain, diarrhea, and constipation are more common in CS with migraine than in CS with non-migrainous headaches. Therefore, evaluation of CD in patients with migraine and these simultaneous GI symptoms seems reasonable.
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Affiliation(s)
- Mohammad M. Fanaeian
- Division of Gastroenterology and Liver Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Alibeik
- Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Azita Ganji
- Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashahd, Iran
| | - Hafez Fakheri
- Gut and Liver Research Center, Non-communicable Disease InstitueMazandaran University of Medical Sciences, Sari, Iran
| | - Golnaz Ekhlasi
- Golnaz Ekhlasi; Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bijan Shahbazkhani
- Department of Gastroenterology and Liver Diseases, Tehran University of Medical Sciences, Tehran, Iran
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Biscetti L, De Vanna G, Cresta E, Corbelli I, Gaetani L, Cupini L, Calabresi P, Sarchielli P. Headache and immunological/autoimmune disorders: a comprehensive review of available epidemiological evidence with insights on potential underlying mechanisms. J Neuroinflammation 2021; 18:259. [PMID: 34749743 PMCID: PMC8573865 DOI: 10.1186/s12974-021-02229-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/04/2021] [Indexed: 12/31/2022] Open
Abstract
Several lines of evidence support a role of the immune system in headache pathogenesis, with particular regard to migraine. Firstly, alterations in cytokine profile and in lymphocyte subsets have been reported in headache patients. Secondly, several genetic and environmental pathogenic factors seem to be frequently shared by headache and immunological/autoimmune diseases. Accordingly, immunological alterations in primary headaches, in particular in migraine, have been suggested to predispose some patients to the development of immunological and autoimmune diseases. On the other hand, pathogenic mechanisms underlying autoimmune disorders, in some cases, seem to favour the onset of headache. Therefore, an association between headache and immunological/autoimmune disorders has been thoroughly investigated in the last years. The knowledge of this possible association may have relevant implications in the clinical practice when deciding diagnostic and therapeutic approaches. The present review summarizes findings to date regarding the plausible relationship between headache and immunological/autoimmune disorders, starting from a description of immunological alteration of primary headaches, and moving onward to the evidence supporting a potential link between headache and each specific autoimmune/immunological disease.
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Affiliation(s)
- Leonardo Biscetti
- Istituto Nazionale di Riposo e Cura dell'Anziano a carattere scientifico, IRCSS- INRCA, Ancona, Italy
| | - Gioacchino De Vanna
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Cresta
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ilenia Corbelli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Lorenzo Gaetani
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Letizia Cupini
- Headache Center, UOC Neurologia-Stroke Unit, Emergency Department, Ospedale S. Eugenio, Rome, Italy
| | - Paolo Calabresi
- Department of Neuroscience, Università Cattolica Sacro Cuore, Rome, Italy
| | - Paola Sarchielli
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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Rivera-Mancilla E, Al-Hassany L, Villalón CM, MaassenVanDenBrink A. Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus. Front Neurol 2021; 12:686398. [PMID: 34177788 PMCID: PMC8219973 DOI: 10.3389/fneur.2021.686398] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Migraine is a disabling neurovascular disorder, characterized by moderate to severe unilateral headaches, nausea, photophobia, and/or phonophobia, with a higher prevalence in women than in men, which can drastically affect the quality of life of migraine patients. In addition, this chronic disorder is related with metabolic comorbidities associated with the patient's lifestyle, including obesity and diabetes mellitus (DM). Beyond the personal and socioeconomic impact caused by migraine, obesity and DM, it has been suggested that these metabolic disorders seem to be related to migraine since: (i) they are a risk factor for developing cardiovascular disorders or chronic diseases; (ii) they can be influenced by genetic and environmental risk factors; and (iii) while clinical and epidemiological studies suggest that obesity is a risk factor for migraine, DM (i.e., type 1 and type 2 DM) have been reported to be either a protective or a risk factor in migraine. On this basis, and given the high worldwide prevalence of migraine, obesity, and DM, this article provides a narrative review of the current literature related to the association between the etiology and pathophysiology of migraine and these metabolic disorders, considering lifestyle aspects, as well as the possible involvement of neurotransmitters, neuropeptides, and/or sex hormones. While a link between migraine and metabolic disorders has been suggested, many studies are contradictory and the mechanisms involved in this association are not yet sufficiently established. Therefore, further research should be focused on understanding the possible mechanisms involved.
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Affiliation(s)
- Eduardo Rivera-Mancilla
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Linda Al-Hassany
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
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12
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Altamura C, Corbelli I, de Tommaso M, Di Lorenzo C, Di Lorenzo G, Di Renzo A, Filippi M, Jannini TB, Messina R, Parisi P, Parisi V, Pierelli F, Rainero I, Raucci U, Rubino E, Sarchielli P, Li L, Vernieri F, Vollono C, Coppola G. Pathophysiological Bases of Comorbidity in Migraine. Front Hum Neurosci 2021; 15:640574. [PMID: 33958992 PMCID: PMC8093831 DOI: 10.3389/fnhum.2021.640574] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Despite that it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bidirectional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involves a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.
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Affiliation(s)
- Claudia Altamura
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Ilenia Corbelli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Bari Aldo Moro University, Policlinico General Hospital, Bari, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,IRCCS-Fondazione Santa Lucia, Rome, Italy
| | | | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Tommaso B Jannini
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberta Messina
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.,Headache Clinic, IRCCS-Neuromed, Pozzilli, Italy
| | - Innocenzo Rainero
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Umberto Raucci
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Elisa Rubino
- Neurology I, Department of Neuroscience "Rita Levi Montalcini," University of Torino, Torino, Italy
| | - Paola Sarchielli
- Clinica Neurologica, Dipartimento di Medicina, Ospedale S.M. Misericordia, Università degli Studi di Perugia, Perugia, Italy
| | - Linxin Li
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Fabrizio Vernieri
- Headache and Neurosonology Unit, Neurology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Catello Vollono
- Department of Neurology, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy
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13
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Zhang DG, Amin FM, Guo S, Vestergaard MB, Hougaard A, Ashina M. Plasma Glucose Levels Increase During Spontaneous Attacks of Migraine With and Without Aura. Headache 2020; 60:655-664. [PMID: 32031249 DOI: 10.1111/head.13760] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/24/2019] [Accepted: 01/07/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate plasma glucose changes during the ictal state of migraine compared to the interictal state. BACKGROUND Previous studies suggest abnormal glucose metabolism in migraine patients during and outside of attacks. It is not known if plasma glucose levels change during spontaneous migraine attacks. METHODS Plasma glucose levels were measured during and outside of spontaneous migraine attacks with and without aura. Plasma glucose values were corrected for diurnal variation of plasma glucose by subtracting the difference between the moving average (intervals of 2 hours) and overall mean from the plasma glucose values. RESULTS This was a sub-study of a larger study conducted at Rigshospitalet Glostrup in the Capital Region of Denmark. Thirty-one patients (24 F, 7 M, 13 with aura, 18 without aura) were included in the study. Mean time from attack onset to blood sampling was 7.6 hours. Mean pain at the time of investigation was 6 on a 0-10 verbal rating scale. Plasma glucose was higher ictally compared to the interictal phase (interictal mean: 88.63 mg/dL, SD 11.70 mg/dL; ictal mean: 98.83 mg/dL, SD 13.16 mg/dL, difference 10.20 mg/dL, 95% CI = [4.30; 16.10]), P = .0014). The ictal increase was highest in patients investigated early during attacks and decreased linearly with time from onset of migraine (-1.57 mg/dL/hour from onset of attack, P = .020). The attack-related increase in blood glucose was not affected by pain intensity or presence of aura symptoms. CONCLUSIONS We demonstrated higher plasma glucose values during spontaneous migraine attacks, independent of the presence of aura symptoms and not related to pain intensity, peaking in the early phase of attacks. Additional studies are necessary to confirm our findings and explore the possible underlying mechanisms.
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Affiliation(s)
- Ditte Georgina Zhang
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Faisal Mohammad Amin
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Song Guo
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Anders Hougaard
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
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14
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Minen MT, Weissman J, Tietjen GE. The Relationship Between Migraine or Severe Headache and Chronic Health Conditions: A Cross-Sectional Study from the National Health Interview Survey 2013-2015. PAIN MEDICINE (MALDEN, MASS.) 2019; 20:2263-2271. [PMID: 31127846 PMCID: PMC7963202 DOI: 10.1093/pm/pnz113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To estimate the prevalence of having at least one or two or more chronic health conditions among US adults with self-reported migraine or severe headaches. DESIGN Cross-sectional study. METHODS Using data collected from the 2013-2015 National Health Interview Survey, we examined adults with and without migraine or severe headache and associations with chronic obstructive pulmonary disease, cancer, heart disease, stroke, diabetes, and hypertension. We calculated point estimates, variances, and 95% confidence intervals and conducted bivariate and multivariable logistic regression modeling to examine the relationships between migraine or severe headache and each of the chronic health conditions, as well as multinomial modeling, to examine the relationship between migraine or severe headache and having one or more chronic health conditions. RESULTS A total of 104,926 people were in the study. Adults aged 18 to 44 years (18.2%), women (20.1%), and those with some college education (17.6%) had the greatest proportion with migraine or severe headache (P < 0.0001). Using multinomial modeling with the number of chronic health conditions as the dependent variable, adults reporting migraine had an increased odds of reporting a single chronic health condition (adjusted odds ratio [aOR] = 1.7, 95% confidence interval [CI] = 1.6-1.8) and more than double the odds of reporting two or more chronic health conditions (aOR = 2.5, 95% CI = 2.3-2.8) compared with adults who did not have migraine or severe headache. CONCLUSIONS Our study confirms observed relationships between migraine or severe headache and chronic health conditions and supports the need for further research to uncover the shared biological pathways.
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Affiliation(s)
- Mia T Minen
- Departments of Neurology and Population Health, NYU Langone Health, New York, New York
| | - Judith Weissman
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - Gretchen E Tietjen
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
- Departments of Neurology and Population Health, NYU Langone Medical Center, New York, New York
- Department of Neurology, University of Toledo, Toledo, Ohio, USA
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15
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Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Does diabetes influence the probability of experiencing chronic low back pain? A population-based cohort study: the Nord-Trøndelag Health Study. BMJ Open 2019; 9:e031692. [PMID: 31515434 PMCID: PMC6747649 DOI: 10.1136/bmjopen-2019-031692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a major problem in modern society and it is important to study possible risk factors for this disorder. People with diabetes are often affected by LBP, but whether diabetes represents a risk factor for LBP has not been studied in detail. The aim of this study was to explore the association between diabetes and subsequent risk of chronic LBP. DESIGN An 11-year follow-up study. SETTING The Nord-Trøndelag Health Study (HUNT2; 1995-1997) and HUNT3 (2006-2008) surveys of Nord-Trøndelag County in Norway. MAIN OUTCOME MEASURE Chronic LBP, defined as LBP persisting at least 3 months continuously during the last year. PARTICIPANTS A total of 18 972 persons without chronic LBP at baseline in HUNT2, and 6802 persons who reported chronic LBP at baseline in HUNT2. METHODS Associations between diabetes and risk of chronic LBP among individuals aged 30-69 years were examined by generalised linear modelling. RESULTS Men without chronic LBP at baseline showed a significant association between diabetes and risk of chronic LBP (relative risk (RR) 1.43, 95% CI 1.04 to 1.96, p=0.043). In women, no association was found (RR 1.01, 95% CI 0.69 to 1.48, p=0.98). No association could be established between diabetes and recurrence or persistence of chronic LBP after 11 years in either sex. CONCLUSIONS Men with a diagnosis of diabetes may have a higher risk of subsequently experiencing chronic LBP.
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Affiliation(s)
- Ingrid Heuch
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St Olavs University Hospital, Trondheim, Norway
| | - Elin Pettersen Sørgjerd
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Endocrinology, St Olavs University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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Abstract
PURPOSE OF THE REVIEW The goals of this review are to evaluate recent studies regarding comorbidity between migraine and different metabolic and endocrine disorders and to discuss the role of insulin resistance as a common pathogenetic mechanism of these diseases. RECENT FINDINGS Recently, several studies showed that migraine is associated with insulin resistance, a condition in which a normal amount of insulin induces a suboptimal physiological response. All the clinical studies that used the oral glucose tolerance test to examine insulin sensitivity found that, after glucose load, there is in migraine patients a significant increase of both plasmatic insulin and glucose concentrations in comparison with controls. On the contrary, no association was found between migraine and type 2 diabetes, while type 1 diabetes seems to have a protective effect in the disease. Obesity and hypertension were shown to be risk factors for both episodic and chronic migraine. Metabolic syndrome has been recently associated mainly with migraine with aura and is now considered a risk factor also for medication overuse headache. Finally, a bidirectional association between migraine and hypothyroidism has been recently demonstrated, suggesting that common genetic or autoimmune mechanisms underlie both diseases. Recent studies showed that insulin receptor signaling and the related physiological responses are altered in migraine and may have a relevant pathogenic role in the disease. Further studies are warranted in order to better elucidate mechanisms underlying insulin resistance in migraine in order to develop new therapeutic strategies for this debilitating disease.
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17
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Muayqil T, Al-Jafen B, Al-Saaran Z, Al-Shammari M, Alkthiry A, Muhammad W, Murshid R, Alanazy M. Migraine and Headache Prevalence and Associated Comorbidities in a Large Saudi Sample. Eur Neurol 2018. [DOI: 10.1159/000487317] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: We aimed to assess the prevalence of headache and migraine, along with comorbidities, in a large Saudi sample. Methods: Self-reported information was collected about headache, migraine and migraine comorbidities including depression, restless legs syndrome (RLS), syncope, bruxism, hypertension and ischaemic disease. The OR was estimated using logistic regression for any associations with headache and migraine. We then analyzed to find a trend of increasing migraine symptoms for each significant comorbidity. Results: Out of 4,943 respondents, 4,158 (84.12%) had recurring headaches. Migraine was present in 1,333 (26.97%), with female predominance (ratio of 1: 2.9). There were statistically significant ORs between migraine and female sex, current smokers, higher income, hypertension, depression, syncope, RLS and bruxism. Non-migraine headaches were significantly associated with female sex, age, RLS and ischaemic disease. Migraine with aura was significantly associated with syncope, ischaemic disease, higher income and BMI. There was an overall significant trend of increasing migraine features in the presence of depression, syncope, RLS, bruxism and hypertension. Conclusions: Headache in general and migraine in particular are associated with multiple comorbidities in comparison to non-headache participants in our cohort, with an estimated prevalence similar to that of western countries.
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18
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Heuch I, Heuch I, Hagen K, Sørgjerd EP, Åsvold BO, Zwart JA. Is chronic low back pain a risk factor for diabetes? The Nord-Trøndelag Health Study. BMJ Open Diabetes Res Care 2018; 6:e000569. [PMID: 30397493 PMCID: PMC6203062 DOI: 10.1136/bmjdrc-2018-000569] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/22/2018] [Accepted: 09/29/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the risk of diabetes associated with the presence or absence of chronic low back pain, considering both cross-sectional and cohort data. RESEARCH DESIGN AND METHODS Analyses were based on the Norwegian HUNT2 and HUNT3 surveys of Nord-Trøndelag County. The prevalence of diabetes was compared in groups with and without chronic low back pain among 45 157 participants aged 30-69 years. Associations between low back pain at baseline and risk of diabetes were examined in an 11-year follow-up of 30 380 individuals with no baseline diagnosis of diabetes. The comorbidity between diabetes and low back pain was assessed at the end of follow-up. All analyses were carried out considering generalized linear models incorporating adjustment for other relevant risk factors. RESULTS Cross-sectional analyses did not reveal any association between low back pain and diabetes. With adjustment for age, body mass index, physical activity and smoking, the cohort study of women showed a significant association between low back pain at baseline and risk of diabetes (RR 1.30; 95% CI 1.09 to 1.54, p=0.003). The association differed between age groups (p=0.015), with a stronger association in relatively young women. In men, no association was found in the whole age range (RR 1.02; 95% CI 0.86 to 1.21, p=0.82). No association was observed between diabetes and chronic low back pain at the end of follow-up. CONCLUSION Among younger women, those with chronic low back pain may have an increased risk of diabetes.
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Affiliation(s)
- Ingrid Heuch
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Ivar Heuch
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Knut Hagen
- Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Advisory Unit on Headaches, St. Olavs University Hospital, Trondheim, Norway
| | - Elin Pettersen Sørgjerd
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU, Norwegian University of Science and Technology, Levanger, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - John-Anker Zwart
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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López-de-Andrés A, Luis Del Barrio J, Hernández-Barrera V, de Miguel-Díez J, Jimenez-Trujillo I, Martinez-Huedo MA, Jimenez-García R. Migraine in adults with diabetes; is there an association? Results of a population-based study. Diabetes Metab Syndr Obes 2018; 11:367-374. [PMID: 30050314 PMCID: PMC6056164 DOI: 10.2147/dmso.s170253] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS To investigate the association between migraine and diabetes mellitus while controlling for several socio-demographic characteristics, comorbidities, and lifestyle variables. We also aimed to identify which of these variables are associated with migraine among diabetics. PATIENTS AND METHODS We conducted a cross-sectional study using data taken from the European Health Interview Surveys for Spain conducted in 2009/10 (n=22,188) and 2014 (n=22,842). We selected those subjects ≥40 years of age. Diabetes status was self-reported. One non-diabetic control was matched by the year of survey, age, and sex for each diabetic case. The presence of migraine was defined as the affirmative answer to both of the following questions: "Have you suffered migraine or frequent headaches over the last 12 months?" and "Has your physician confirmed the diagnosis?". Independent variables included demographic and socio-economic characteristics, health status variables, lifestyle, and pain characteristics. RESULTS The prevalence of migraine was significantly higher among those suffering from diabetes (14.9% vs. 13.0%; p=0.021). The multivariable analysis showed that diabetes was not associated with a higher risk of migraine (adjusted OR 1.06; 95%CI 0.89-1.25). Among diabetic subjects, female sex, suffering concomitant mental disorders, respiratory disorders, neck pain, and low back pain were variables associated with suffering from migraine. CONCLUSION We found no significant differences in the prevalence of migraine between diabetics and non-diabetic age- and sex-matched controls after controlling for possible confounders.
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Affiliation(s)
- Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain,
| | - José Luis Del Barrio
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain,
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain,
| | - Javier de Miguel-Díez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Isabel Jimenez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain,
| | - María Angeles Martinez-Huedo
- Preventive Medicine and Public Health Department, Teaching and Research Unit, University Hospital La Paz, Madrid, Spain
| | - Rodrigo Jimenez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain,
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