Prevalence of Migraine Headache in Taif City, Saudi Arabia

Sexual dysfunction in migraine-affected women: A prospective cross-sectional controlled study

Introduction

Female sexual dysfunction (FSD) is a common health problem that is inadequately investigated in Arabic countries, especially Saudi Arabia.

Aim

To assess the prevalence and trace predictors of FSD in Saudi women who suffered from migraine headaches comparable to healthy women.

Patients and methods

A prospective cross-sectional, controlled study involved 400 Saudi women complaining of migraine (Case Group) and another 400 healthy-looking Saudi women (Control Group) during three months; from January 1st, to March 31st 2023, in Jeddah city, Saudi Arabia. Data was collected by using a pre-structured Female Sexual Function Index (FSFI) questionnaire, Female Sexual Distress Scale (FSDS), Migraine Screen Questionnaire (MS-Q), with an evaluation of the severity of pain by Visual Analogue Scale (VAS), and its impact on daily activity by using both; Headache Impact Test (HIT-6) and Migraine Disability Assessment (MIDAS) Questionnaire.

Results

A total of 800 Saudi women were recruited. Their ages ranged from 18 to 45 years old. Women with abnormally low FSFI scores were 375 (93.75 %) out of 400 with migraine and 85 (21.25 %) out of 400 without migraine. The lowest FSFI scores were mainly for desire (2.75 ± 1.05) and arousal domains (3.0 ± 1.12) followed by sexual satisfaction (3.25 ± 1.30) and orgasmic domains (3.5 ± 1.15). The foremost predictive factor behind low FSFI scores and associated FSD in our study was migraine (P < 0.00001). Additional predictors of statistical significance were low educational level (P < 0.01), urban residency (P < 0.02), high parity (P < 0.02), chronic illness such as diabetes (P < 0.01), and bad habits such as smoking (P < 0.03).

Conclusion

A significant correlation exists between migraine and female sexual dysfunction (FSD). Desire and arousal dysfunctions were the most significantly affected domains followed by satisfaction and orgasmic problems.

Understanding migraine in Saudi society: An assessment of public knowledge and attitudes: A cross-sectional study

OBJECTIVE

This study aims to assess the knowledge and perceptions of the public toward migraine in Saudi Arabia.

METHODS

This cross-sectional survey assessed the knowledge and perceptions of migraine among Saudi Arabian individuals. The study was conducted over three months in 2023 (1st of June 2023 to 31st of August 2023) using a prevalidated online questionnaire divided into four sections.

RESULTS

A total of 1,975 adults aged between 18 and 64 completed the web-based survey. Of these, over half were male (n = 1,268; 64.2%). The main causes of migraine identified by the participants were genetic disease (n = 540, 27.3%), followed by physical disease (n = 341, 17.3%), head trauma (n = 274, 13.9%), and psychiatric disease (n = 157, 7.9%). The main symptoms identified by the participants were photophobia (21%), followed by inability to control urine (14.1%), vomiting and nausea (13.8%), and vision loss (8.3%). The majority of the participants in this study had a good knowledge of migraines, while 49% had poor knowledge. The migraine knowledge score was significantly associated with the participants' gender (p = 0.002), age (p = 0.0001), educational level (p = 0.001), employment status (p = 0.001), monthly income (p = 0.0001), region (p = 0.0001), and history of migraine (p = 0.0001).

CONCLUSION

Although one-third of the participants exhibiting good knowledge, deficiencies existed in certain clinical aspects, emphasizing the need for targeted educational interventions to enhance public awareness and understanding of migraines.

Examining the Impact of Puberty on Primary Headache Disorders in Female Schoolchildren: A Cross-Sectional Study

Introduction and aim Headaches are one of the most prevalent childhood disorders. Primary and secondary headaches are the two types of headaches affecting kids and teenagers. The three most typical primary headache forms are tension-type headaches (TTH), migraine, and cluster headaches. This study sought to determine the relationship between puberty and types of headaches. Methods This cross-sectional study was conducted from May 18 to July 31, among female schoolchildren aged between eight and 15 years in the Eastern Province of Saudi Arabia. Respondents were recruited through face-to-face interviews. A self-administered questionnaire was utilized, mainly consisting of demographic data and questions related to diagnosing and managing the impact of puberty in girls on the prevalence of primary headache disorder. Results In total, 481 female schoolchildren were interviewed, mostly between 13 and 15 years old (65.9%). Last year prevalence of headaches was 65.5%, with a significant difference among those who lived in Dhahran (p=0.001) and those with a family history of headaches (p<0.001). The most common type of headache was frequent TTH (16.4%) and chronic TTH (16%). Chronic TTH (p<0.001), frequent TTH (p<0.001), and migraine without aura (p=0.005) were significantly more common among the older age groups.  Conclusion There was a high prevalence of headaches among female schoolchildren, with frequent TTH and chronic TTH being the most common. Furthermore, increasing age was associated with an increasing risk for chronic TTH, frequent TTH, and migraine headaches without aura. More epidemiological studies are necessary to determine the underlying causes of headaches among schoolchildren.

Migraine and Irritable Bowel Syndrome Among the General Population in Aseer Region

BACKGROUND

Limited research has been conducted in Saudi Arabia to investigate the incidence and understanding of migraines and irritable bowel disease (IBS) among the population. This study aimed to quantify the prevalence of migraine and IBS within the Aseer region. Furthermore, it aimed to explore the potential association between migraine and IBS.

METHODS

The survey questionnaire was distributed through various social media platforms such as Facebook (Meta Platforms, Inc., Menlo Park, California, United States), Twitter/X (X Corp., San Francisco, California, United States), LinkedIn (Microsoft Corporation, Sunnyvale, California, United States), and WhatsApp (Meta Platforms, Inc.) to maximize the reach and engagement of potential participants. The Migraine Screen Questionnaire (MS-Q) assessed the type and frequency of headache pain, along with intensity and impact on daily activities. The questionnaire also incorporated the Rome IV diagnostic criteria for IBS.

RESULTS

 A total of 683 participants were included in this study; 65.2% were aged 21-39 years, 85.5% were females, 61.6% were single, and 73.1% had a university degree or higher. Of the participants, 45.97% experienced migraines, while 39.97% exhibited symptoms of IBS. There was a statistically significant association between having IBS and migraine (χ2 = 11.88, p 0.001). Migraine was significantly associated with female sex (p = 0.049), history of psychiatric disease (p < 0.001), and family history of migraines (p < 0.001). IBS was significantly associated with age (p = 0.042), history of psychiatric disease (p = 0.015), and sleeping hours (p = 0.038).

CONCLUSIONS

This study reveals a high prevalence of migraine and IBS, underlining their interconnection. Key risk factors include age, gender, family history, and psychiatric disorders. Targeting high-risk groups is crucial due to the substantial impact on daily life and performance.

Prevalence of Migraine Headache in Saudi Arabia: A Systematic Review and Meta-Analysis

BACKGROUND

Migraine is an important healthcare concern that silently affects diverse populations globally. The rising prevalence of migraine affects the quality of life of individuals, the economic burden of a nation, and work productivity. This study was designed to determine the prevalence of migraine in Saudi Arabia.

METHODOLOGY

A systematic data search was designed, and scientific data were collected from leading databases, including PubMed, The Cochrane Library, Web of Science, Ovid, and Google Scholar.

RESULTS

Thirty-six studies, comprising 55061 study participants based on defined inclusion criteria, were statistically analyzed using StatsDirect software. The pooled proportion of migraine in Saudi Arabia among all 36 selected studies was 0.225617 (95% confidence interval (CI) = 0.172749 to 0.28326). The study was grouped into four categories: general population, students (of both genders), studies based on females only, and healthcare professionals in primary health care (PHC). The migraine pooled proportion among all four groups using random effects (DerSimonian-Laird) was 0.213822 (95% CI = 0.142888 to 0.294523), 0.205943 (95% CI = 0.127752 to 0.297076), 0.345967 (95% CI = 0.135996 to 0.593799), and 0.167068 (95% CI = 0.096429 to 0.252075), respectively.

CONCLUSION

The estimated pooled proportion of migraine in Saudi Arabia is 0.225617, which is comparable to or even higher than other parts of the Middle East region. Migraine has a great impact on quality of life, productivity, and economic capacity, and increases the healthcare burden. Early detection and necessary lifestyle measures are necessary to minimize this number.

The variability of diagnosed migraine epidemiology amongst different municipalities in southern Israel

BACKGROUND

Appropriate and timely diagnosis is one of the most important milestones in effective migraine care and is affected by public awareness, access to medical care, health care systems, and physicians' knowledge. We assessed the variability in migraine diagnosis rates in different communities under universal national health coverage in Israel.

METHODS

In this population-based retrospective, observational, cohort study, adult (≥18 years) migraine patients were identified in the computerized database of the southern district of the Clalit Health Services Health Maintenance Organization (HMO) based on recorded diagnosis and/or purchase of specific anti-migraine acute medication (triptans). Migraine prevalence in 2018 was calculated in the entire study population and in different municipalities. We utilized a standardized (age and gender) mortality ratio (SMR) approach for comparison among the municipalities.

RESULTS

In 2018, a total of 29,938 migraine patients were identified out of 391,528 adult HMO members, with an overall prevalence (per 10,000) of migraine of 764.64 (7.65%), 1143.34 (11.43%) for women, and 374.97 (3.75%) for men. Among the municipalities, adjusted prevalence (per 10,000) ranged from 386.15 (3.86%) to 1320.60 (13.21%). The female-to-male ratio ranged from 1.8:1 to 5.1:1. Prevalence rates were positively associated with the socioeconomic status of the municipalities (Spearman rho = 0.472, P = 0.031).

CONCLUSIONS

High variability in the prevalence of diagnosed migraine suggests underdiagnosis. Resources for awareness and educational programs should be directed to low diagnosed prevalence communities.

Whole-Exome Sequencing Reveals Migraine-Associated Novel Functional Variants in Arab Ancestry Females: A Pilot Study

Migraine, as the seventh most disabling neurological disease with 26.9% prevalence in Saudi females, lacks studies on identifying associated genes and pathways with migraines in the Arab population. This case control study aims to identify the migraine-associated novel genes and risk variants. More than 1900 Arab ancestry young female college students were screened: 103 fulfilled the ICHD-3 criteria for migraine and 20 cases confirmed in the neurology clinic were included for the study with age-matched healthy controls. DNA from blood samples were subjected to paired-end whole-exome sequencing. After quality control, 3365343 missense, frameshift, missense splice region variants and insertion-deletion (indels) polymorphisms were tested for association with migraine. Significant variants were validated using Sanger sequencing. A total of 17 (p-value 9.091 × 10-05) functional variants in 12 genes (RETNLB, SCAI, ADH4, ESPL1, CPT2, FLG, PPP4R1, SERPINB5, ZNF66, ETAA1, EXO1 and CPA6) were associated with higher migraine risk, including a stop-gained frameshift (-13-14*SX) variant in the gene RETNLB (rs5851607; p-value 3.446 × 10-06). Gene analysis revealed that half of the significant novel migraine risk genes were expressed in the temporal lobe (p-value 0.0058) of the cerebral cortex. This is the first study exploring the migraine risk of 17 functional variants in 12 genes among Saudi female migraineurs of Arab ancestry using whole-exome sequencing. Half of the significant genes were expressed in the temporal lobe, which expands migraine pathophysiology and early identification using biomarkers for research possibilities on personalised genetics.

Quality of life and its predictors among patients with migraine in Qassim region, Saudi Arabia: a cross-sectional study

Background

Migraine attacks can last for hours to days with severe pain which can affect the daily activities. Literature on quality of life of migraineurs is Saudi Arabia is scarce. This study aimed to assess the quality of life and its predictors among patients with migraine in Qassim region, Saudi Arabia.

Methods

A cross-sectional study was conducted among patients with migraines in Qassim, Saudi Arabia. A self-administered questionnaire was distributed online among migraine patients that included; socio-demographic characteristics and an Arabic version of validated migraine-specific quality of life questionnaire (MSQ), version 2.1. Data analyses were performed in SPSS version 26.

Results

A total of 320 patients with migraines participated in the study. The most common age group was 18–25 years (36.6%) with females were dominant (60.9%). According to the results of MSQ version 2.1, the mean ± SD scores of Role Restrictive (RR), Role Preventive (RP), and Emotion Function (EF) were 67.7 ± 19.7, 68.5 ± 20.6, and 70.6 ± 22.1, respectively. Statistical tests revealed that patients who reported less frequent migraine attacks, had better scores in RR, RP, and EF, while the use of paracetamol and painkillers for the treatment of headache were associated with lower scores in RR, RP, and EF.

Conclusions

The quality of life among patients with migraines was generally moderate. Males demonstrated better QOL than females. Furthermore, patients who had less frequent migraine attacks exhibited better QOL than the others but working patients were likely to demonstrate poor QOL.

Association of Migraine and Irritable Bowel Syndrome in Saudi Arabia: A Nationwide Survey

Migraine is a primary headache disorder with a prevalence of 11.6% globally and 27% in Saudi Arabia. Irritable bowel syndrome (IBS) has a prevalence of 9.2% worldwide. The prevalence of IBS has not been established nationally. However, provincial studies for migraine and IBS have been conducted nationwide. There is a significant link between migraine and IBS globally. Migraineurs had a considerably greater prevalence of IBS than nonmigraineurs (OR = 2.49, 95% CI 2.22-2.78). Patients with IBS have 60% higher odds for migraines. This identifies an association that needs to be investigated in a nationwide manner. The study has two main aims. The first is to measure the prevalence of migraine and irritable bowel syndrome in Saudi Arabia. The second is to observe the association and the relationship between migraine and irritable bowel syndrome in Saudi Arabia. A cross-sectional study was conducted among the general population of Saudi Arabia between March 2021 and June 2021, whose ages are 15 years old or greater. Participants filled an online self-administered survey. The data collection tools included the Migraine Screen Questionnaire (MS-Q) for migraine symptoms, migraine severity (MIGSEV) scale for severity of migraine, and the IBS module of the Rome IV Diagnostic Questionnaire (R4DQ) for IBS symptoms and their subtype. With 2802 participants, the majority of the study samples were males, who constituted 52.5%. Among the study's sample, the prevalence of migraine consisted of 27.4%, and the prevalence of IBS was 16.4%. The odds of having IBS in migraineurs were much higher than in those without migraine (OR 4.127; 95% CI 3.325-5.121), and the association was statistically significant (p < 0.001). In conclusion, there is a strong association between migraine and irritable bowel syndrome in Saudi Arabia.

Migraine-Related Disabilities Among Saudi Migraine Patients and Its Association with Social Factors

Background: Migraine is a complex disorder triggered by an interaction of multiple abnormalities involving genes, blood vessels, and brain structures. It is characterized by throbbing headaches, mostly on one side of the head. It is one of the most common causes of disability, as announced by the Global Burden of the Diseases (GBD). Objectives: We aimed at assessing disabilities in Saudi migraine patients and addressing the relation between migraine-associated disabilities and social factors in Saudi Arabia. Methods: We conducted a web-based survey randomly through social media channels to the general population around Saudi Arabia. Basic personal information, along with a confirmation of the migraine diagnosis, were included in the first part of the questionnaire, and the respondent’s eligibility was determined to complete the survey. Specified questions about the sociodemographic characteristics, migraine attacks and medications, and the items of Migraine Disability Assessment score (MIDAS), were included in the next parts of the survey. Results: Of the 480 total responses, 250 (52.1%) eligible participants were included (mean age of 34.84 ± 10.14 years; 83.2% females). Most of the participants were married (59.6%), had three or more kids (50.7%), had a bachelor’s degree (60.8%), and 52.8% were employed. Only 16.4% of the subjects did regular exercise, and 16.8% were current smokers. No significant association was detected between the MIDAS score and most of the social characteristics, including marital status, number of kids, education level, occupation, and smocking. Conclusions: Most of the migraineurs in Saudi Arabia had a severe disability according to the MIDAS score. Gender, regular exercise, the severity of the disease, and frequency of attack had a statistically significant relationship with migraine-related disabilities. Migraine treatment and prophylaxis were incompetent in decreasing migraine severity and related disabilities in our selected participants.

Levels and determinants of knowledge about chronic migraine diagnosis and management among primary health-care physicians in ministry of health, Jeddah 2019

Background:

Chronic migraine (CM) poses a significant burden for patients, and it has multiple diagnostic and managemental challenges, particularly among primary health-care physicians (PCPs).

Objectives:

The objective of this study is to assess the levels of knowledge regarding CM diagnosis and management among PCPs and to explore the factors associated with poor knowledge.

Methods:

A cross-sectional study was conducted among PCPs working at primary health-care centers in Jeddah, Saudi Arabia. A semi-structured questionnaire comprising 20 items related to CM diagnosis and treatment was used.

Results:

A total of 136 PCPs responded (aged 36.4 ± 8.1, 68.4% were females). The overall median (P75) knowledge score was 13.0 (15.0), and 45.6% of the participants had adequate knowledge (score > median). The majority of respondents (>50%) could not identify the lower limits of CM duration, the necessity of identifying at least eight migraine attacks in a month, the importance of managing medication overuse, and the indication of topiramate as the most efficacious agent in CM. Young physicians (23–35 years), bachelor graduates, general practitioners (GPs), and those having ≤5 years of experience scored lower than their peers. Physicians with 6–10 years of clinical experience were independently more knowledgeable than less-experienced PCPs (odds ratio = 5.09, P = 0.006).

Conclusion:

Knowledge regarding CM diagnosis and treatment was inadequate among PCPs, which could detrimentally influence the patterns of referral to secondary health-care facilities. Given these observations, it is recommended to amend the academic curricula for medical students/GPs and adopt continuing medical education programs for PHPs to support their levels of knowledge.

The Epidemiology of Migraine Headache in Arab Countries: A Systematic Review

Background

Recurring migraine disorders are a common medical problem, standing among the top causes of disability and sufferings. This study aimed to evaluate epidemiological evidence to report updated estimates on prevalence, risk factors, and associated comorbidities of migraine headache in the Arab countries. Design and Setting. A systematic review was conducted at the College of Public Health and Health Informatics, Riyadh, Saudi Arabia.

Methods

A systematic search in electronic databases, such as PubMed and Embase, as well as manual searches with cross-referencing was performed from 1990 up to 2019. Overall, 23 included papers were rated independently by two reviewers. Studies were eligible for inclusion only if they investigated migraine headache epidemiology in any Arab country and were published in English.

Results

Migraine prevalence among the general population ranged between 2.6% and 32%. The estimated prevalence of migraine headache among medical university students ranged between 12.2% and 27.9% and between 7.1% and 13.7% in schoolchildren (6 to 18 years). Females were found more likely to have migraine than males. The duration of migraine attacks became shorter with increasing age, while chronic (daily) migraine showed increasing prevalence with age. The most commonly reported comorbidities with migraine included anxiety, hypertension, irritable bowel syndrome, and depression. Most common headache-triggering factors included stress, fatigue, sleep disturbances, prolonged exposure to excessive sunlight or heat, and hunger.

Conclusion

The prevalence and risk factors of migraine headache in Arab countries are comparable to reports from western countries. Longitudinal studies are still needed to investigate the prognosis and predictors of chronicity in the arab countries.

Prevalence of migraine and non-migraine headache and its relation with other diseases in the adults of Aseer Region, Saudi Arabia

Background and Aims:

Headache is a common yet neglected health problem. There is a lack of information about its distribution, disease characteristics and associated co morbidities in Aseer region of KSA. This study aims to estimate the migraine and headache prevalence, its epidemiological and disease characteristics and relation with other co morbid conditions among general population of Aseer region, Saudi Arabia.

Methods:

A descriptive cross-sectional survey of 1123 adult participants during the period from Apr 2018 to Dec 2018. The questionnaire was sent to total of 1420 participants, but only 1123 agreed to participate and completed the questions (response rate 79.1%). Participants were recruited through an online survey from 4 main cities in Aseer region. Participants who refused were excluded. Adults were invited to answer a 25-question electronic survey to assess the prevalence of headache (migraine and non-migraine) and its relations with other diseases.

Results:

The participant's ages ranged from 17 to 60 years old, with mean age of 32.4 ± 10 years. No history of frequent headaches was reported by 152 (13.5%) while 833 (74.2%) had non-migraine headache (NMH) and 138 (12.3%) had migraine headache (MH). Female gender (2:1), poor sleep duration, cerebrovascular disease, dyslipidemia, chronic sinusitis and depression showed a significant association with migraine.

Conclusions and Recommendations:

The current research revealed a high prevalence of headache either migraine or non-migraine, twice as common in females and in those with insufficient sleeping hours. Most headache attacks were associated mainly with light in form of flashes, sensitivity or aggravated episodes.

Quality of life of migraine patients followed in neurology clinics in Riyadh, Saudi Arabia

BACKGROUND

Migraine is a chronic disorder that negatively affects a patient's quality of life (QOL). As little is known about the QOL of migraine sufferers in Saudi Arabia, our aim was to investigate the QOL and the level of migraine-associated disability of migraine patients.

MATERIALS AND METHODS

This cross-sectional study was conducted in neurology clinics at King Abdulaziz Medical City for National Guard and Prince Sultan Military Medical City in Riyadh, Saudi Arabia, from August to December 2018. The migraine-specific QOL questionnaire (MSQ), version 2.1, was used to measure restrictive, preventive, and emotional domains. The sum of the item responses ranged between 0 and 100, with higher scores indicating better QOL. A descriptive analysis of numerical variables was reported in terms of means and standard deviation, while categorical variables were described using frequencies and percentages.

RESULTS

A total of 300 migraine patients completed the questionnaire; 67% were females. Age of participants ranged from 20 to 53 years, with mean age of 34.21 (SD=7.26). The mean score in the QOL restrictive domain was 51.8 ± 19, whereas the mean scores for preventive and emotional domains were 54 ± 18 and 46.3 ± 23.4, respectively. Low QOL scores were associated with young ages, long disease duration, frequent migraine attacks, and presence of chronic diseases.

CONCLUSION

Chronic migraine has a negative impact on QOL, predominantly in young patients, patients with frequent attacks, those not using preventive medications, and those suffering from chronic diseases.