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Błaszczyk B, Straburzyński M, Więckiewicz M, Budrewicz S, Niemiec P, Staszkiewicz M, Waliszewska-Prosół M. Relationship between alcohol and primary headaches: a systematic review and meta-analysis. J Headache Pain 2023; 24:116. [PMID: 37612595 PMCID: PMC10463699 DOI: 10.1186/s10194-023-01653-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Headache is one of the most common neurological symptoms. Many previous studies have indicated a relationship between primary headaches and alcohol. Drinking has been associated with increased risk of tension-type headache (TTH) and migraine. However, recently published studies have not confirmed this relationship. The existing literature is inconclusive; however, migraine patients avoid alcohol. Therefore, the primary objective was to provide a reliable assessment of alcohol intake in people with primary headaches; the secondary objective was to identify any potential relationship between alcohol consumption and headache risk. METHODS This study was based on PubMed, Embase and Web of Science database searches performed on 11 July 2023. This systematic review was registered in PROSPERO (CRD42023412926). Risk of bias for the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analyses were performed using Statistica software. The Risk Ratio (RR) was adopted as the measure of the final effect. Analyses were based on a dichotomous division of the respondents into "non-drinkers" and "drinkers" for headache patients and matched non-headache groups. RESULTS From a total of 1892 articles, 22 were included in the meta-analysis. The majority demonstrated a moderate or high risk of bias. The first part of the meta-analysis was performed on data obtained from 19 migraine studies with 126 173 participants. The risk of migraine in alcohol drinkers is approximately 1.5 times lower than in the group of non-drinkers (RR = 0.71; 95% CI: 0.57-0.89). The second part involved 9 TTH studies with 28 715 participants. No relationship was found between TTH diagnosis and alcohol consumption (RR = 1.09; 95% CI: 0.93-1.27). Two of the included cluster-headache articles had inconclusive results. CONCLUSIONS Alcohol consumption and migraine are inversely correlated. The exact mechanism behind this observation may indicate that migraine leads to alcohol-avoidance, rather than alcohol having any protective role against migraine. There was no relationship between TTH and drinking. However, further studies related to primary headaches and alcohol consumption with low risk of bias are required. Additionally, patients and physicians should consider the latest medical data, in order to avoid the myths about alcohol consumption and primary headaches.
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Affiliation(s)
| | - Marcin Straburzyński
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
| | - Mieszko Więckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213 Str, 50-556, Wroclaw, Poland
| | - Piotr Niemiec
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
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Ciaramitaro P, Rota E, Ferraris M, Stura I, Migliaretti G, Cocito D. Migraine in Chiari 1 Malformation: a cross-sectional, single centre study. Acta Neurol Belg 2021; 122:947-954. [PMID: 34047952 DOI: 10.1007/s13760-021-01716-z] [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: 04/17/2021] [Accepted: 05/19/2021] [Indexed: 11/29/2022]
Abstract
In Chiari 1 Malformation (CM1) the most frequent symptom is exertional headache, but other headache types have been reported, such as migraine. This cross-sectional study is aimed to examine the prevalence of migraine in a group of CM1 headache patients and to compare clinical-demographic characteristics between migraine and non-migraine patients. 427 adults were enrolled at the multidisciplinary Chiari Center in Torino. 230 headache patients were classified, based on radiological criteria. Frequencies (absolute/percentage values) were calculated in the whole sample for: migraine presence (with and without aura), gender, age, radiologic phenotypes and headache clinical characteristics. The association between CM1 diagnosis and headache characteristics (independent variables) and migraine diagnosis (dependent variable) was estimated by logistic regression models. Seventy-eight patients (67 females) out of 230 presenting headache had a migraine (34%), 44/78 (56%) with aura; in 58/78 (74%) migraine was comorbid with secondary headache attributable to CM1. Migraine prevalence in patients with isolated CM1 (52/120, 43.3%) was higher (p = 0.0016) than in all the other patients (26/110, 23.6%). Although migraine was prevalent in females (86%; 6:1 female:male ratio), age classes and gender were not risk factors for migraine at multivariate analysis, while migraine was associated with isolated CM1 phenotype (OR = 2.6). This study shows a high prevalence of migraine in CM1 patients and a significant association between migraine and isolated CM1. In patients with radiological evidence of CM1, particularly in the absence of neurological signs, a careful headache clinical characterization, according to the International Headache Society criteria, may be advised.
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Affiliation(s)
- Palma Ciaramitaro
- Centro Regionale Esperto Siringomielia e Sindrome di Chiari (CRESSC), Department of Neuroscience, AOU Città della Salute e della Scienza di Torino, Presidio CTO, Via Zuretti, 29, 10126, Turin, Italy.
| | - Eugenia Rota
- Neurology Unit, San Giacomo Hospital, Novi Ligure, ASL Alessandria, Novi Ligure, Italy
| | - Marilena Ferraris
- Diagnostic Imaging Department, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Ilaria Stura
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | - Giuseppe Migliaretti
- Department of Public Health and Paediatric Sciences, University of Torino, Torino, Italy
| | - Dario Cocito
- Centro Regionale Esperto Siringomielia e Sindrome di Chiari (CRESSC), Department of Neuroscience, AOU Città della Salute e della Scienza di Torino, Presidio CTO, Via Zuretti, 29, 10126, Turin, Italy
- Istituti Clinici Scientifici Maugeri, Pavia, Italy
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Rohmann JL, Rist PM, Buring JE, Kurth T. Migraine, headache, and mortality in women: a cohort study. J Headache Pain 2020; 21:27. [PMID: 32183686 PMCID: PMC7079482 DOI: 10.1186/s10194-020-01091-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Migraine carries a high global burden, disproportionately affects women, and has been implicated as a risk factor for cardiovascular disease. Migraine with aura has been consistently associated with increased risk of cardiovascular mortality. However, published evidence on relationships between migraine or non-migraine headache and all-cause mortality is inconclusive. Therefore, we aimed to estimate the effect of non-migraine headache and migraine as well as migraine subtypes on all-cause and cause-specific mortality in women. METHODS In total, 27,844 Women's Health Study participants, aged 45 years or older at baseline, were followed up for a median of 22.7 years. We included participants who provided information on migraine (past history, migraine without aura, or migraine with aura) or headache status and a blood sample at study start. An endpoints committee of physicians evaluated reports of incident deaths and used medical records to confirm deaths due to cardiovascular, cancer, or female-specific cancer causes. We used multivariable Cox proportional hazards models to estimate the effect of migraine or headache status on both all-cause and cause-specific mortality. RESULTS Compared to individuals without any headache, no differences in all-cause mortality for individuals suffering from non-migraine headache or any migraine were observed after adjustment for confounding (HR = 1.01, 95%CI, 0.93-1.10 and HR = 0.96, 95% CI: 0.89-1.04). No differences were observed for the migraine subtypes and all-cause death. Women having the migraine with aura subtype had a higher mortality due to cardiovascular disease (adjusted HR = 1.64, 95%CI: 1.06-2.54). As an explanation for the lack of overall association with all-cause mortality, we observed slightly protective signals for any cancer and female-specific cancers in this group. CONCLUSIONS In this large prospective study of women, we found no association between non-migraine headache or migraine and all-cause mortality. Women suffering from migraine with aura had an increased risk of cardiovascular death. Future studies should investigate the reasons for the increased risk of cardiovascular mortality and evaluate whether changes in migraine patterns across the life course have differential effects on mortality.
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Affiliation(s)
- Jessica L Rohmann
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany
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Jokonya L, Makarawo S, Mduluza-Jokonya TL, Ngwende G. Fatal status migrainosus in Chiari 1 malformation. Surg Neurol Int 2020; 10:243. [PMID: 31893144 PMCID: PMC6935960 DOI: 10.25259/sni_491_2019] [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: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 11/07/2022] Open
Abstract
Background: Headaches are common in Chiari Type 1 malformation (CM-1). The prevalence of migraine headaches in CM-1 is similar to that of the general population. However, when migraine headaches occur with CM-1, they tend to have an earlier age of onset, are more frequent and certainly more severe than when they occur without CM-1 association. The exact role or impact of CM-1 in migraine headaches has not been fully elucidated. Case Description: We report a fatal case of status migrainosus in 7 years old with CM-1 and review the literature on the possible associations. Conclusion: Migraines occurring in association with CM-1 pose a management challenge and can be potentially fatal especially if associated with autonomic symptoms. The exact pathophysiological interaction between these two conditions when they occur simultaneously needs to be further elucidated.
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Affiliation(s)
- Luxwell Jokonya
- Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sydney Makarawo
- Department of Surgery, Parirenyatwa Hospital, Harare, Zimbabwe
| | | | - Gift Ngwende
- Department of Medicine, University of Zimbabwe, Harare, Zimbabwe
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Jeyagurunathan A, Abdin E, Vaingankar JA, Chua BY, Shafie S, Chang SHS, James L, Tan KB, Basu S, Chong SA, Subramaniam M. Prevalence and comorbidity of migraine headache: results from the Singapore Mental Health Study 2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:33-43. [PMID: 31456029 DOI: 10.1007/s00127-019-01755-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. Studies have revealed that those with migraine headache and coexisting psychiatric disorders have poorer treatment outcomes and increased disability. The study aims to establish the prevalence, correlates, and comorbidities of migraine headache among the multi-ethnic Asian population in Singapore. METHOD Data were extracted from the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional epidemiological survey of a nationally representative sample. Face-to-face interviews were completed with 6126 participants between 2016 and 2017. The data relating to chronic medical conditions, psychiatric conditions, and 30-day functioning and disability were captured using the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0. RESULTS The lifetime prevalence for migraine headache in the Singapore general population was 8.2%. Malay ethnicity (versus Chinese), female gender (versus male), and diploma holders (versus university) were significantly more likely to experience migraine headache. Participants belonging to the older age group (65 years and above versus 18-34 years of age), and those who were economically inactive (versus employed) were less likely to experience migraine headache. The mean age of onset for migraine was 26.4 years (SD = 11.1). Poisson regression analyses showed that migraine headache was also significantly associated with psychiatric conditions such as major depressive disorder (MDD) (prevalence ratio (PR), 1.80; 95% CI, 1.25-2.58), bipolar disorder (BD) (PR, 3.55; 95% CI, 2.29-5.51), generalized anxiety disorder (GAD) (PR, 2.04; 95% CI, 1.12-3.69), obsessive compulsive disorder (OCD) (PR, 2.20; 95% CI, 1.49-3.26), and alcohol use disorder (AUD) (PR, 1.93; 95% CI, 1.20-3.08). Those with migraine headache were significantly associated with poor functioning and disability compared to those without migraine headache. CONCLUSIONS AND DISCUSSION Our study showed significant associations between migraine headache and psychiatric disorders, as well as with role functioning and disability. The findings of our study emphasise the need for screening for psychiatric comorbidity among those with migraine and the development of appropriate interventions for this group.
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Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shi Hui Sherilyn Chang
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Lyn James
- Ministry of Health (MOH), Singapore, Singapore
| | | | - Sutapa Basu
- Early Psychosis Intervention Programme (EPIP), Department of Psychosis, IMH, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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