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Rodrigues A, Carvalho GF, Florencio LL, Martins J, Pinheiro-Araújo CF, Rosa MDD, Dach F, Bevilaqua-Grossi D. Reliability and construct validity of the Craniocervical Flexion Test in patients with migraine. Braz J Phys Ther 2024; 28:101085. [PMID: 38936314 PMCID: PMC11260925 DOI: 10.1016/j.bjpt.2024.101085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 04/04/2024] [Accepted: 06/02/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Migraine may be accompanied by several cervical musculoskeletal dysfunctions, for example an altered performance on the Craniocervical Flexion Test (CCFT). However, CCFT measurement properties are still unclear in patients with migraine. OBJECTIVES To determine intra- and inter-examiner reliability, construct validity, standard measurement error (SEM), and minimal detectable change (MDC) of the CCFT in patients with migraine. METHODS Women diagnosed with migraine were considered eligible for this study. Participants were assessed by two examiners for the inter-examiner reliability, and with 7-10 days interval for the intra-examiner reliability. Construct validity was assessed considering headache and neck pain frequency and intensity, and self-reported questionnaires, including the Headache Impact Test - 6 items (HIT-6), the 12-item Allodynia Symptom Checklist/Brazil (ASC-12), and the Neck Disability Index (NDI). In addition, participants performed cervical endurance and maximal voluntary isometric contraction of the cervical flexors. RESULTS A total of 103 women with migraine were recruited. The intra-examiner reliability was rated as good (ICC= 0.81, 95% CI: 0.73, 0.87), while the inter-examiner reliability was rated as moderate (ICC= 0.55, 95% CI: 0.40, 0.67). The intra and inter-examiner SEM were 1.31 and 1.36 mmHg respectively, and MDC were 3.63 and 3.77 mmHg. The HIT-6 and the cervical endurance flexion test were associated with the CCFT in a multiple linear regression model (p = 0.004, R = 0.35). CONCLUSION The CCFT presents adequate intra- and inter-examiner reliability. Better performance on the CCFT test was associated with better HIT-6 scores and greater cervical endurance time, which was not influenced by the presence of neck pain.
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Affiliation(s)
- Amanda Rodrigues
- Department of Health Sciences, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Gabriela Ferreira Carvalho
- Department of Physical Therapy, Faculty of Health, Safety and Society, Furtwangen University, Furtwangen, Germany
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.
| | - Jaqueline Martins
- Department of Health Sciences, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Milena Dietrich Deitos Rosa
- Department of Health Sciences, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Montisano DA, Giossi R, Canella M, Altamura C, Marcosano M, Vernieri F, Raggi A, Grazzi L. Reducing the Impact of Headache and Allodynia Score in Chronic Migraine: An Exploratory Analysis from the Real-World Effectiveness of Anti-CGRP Monoclonal Antibodies Compared to Onabotulinum Toxin A (RAMO) Study. Toxins (Basel) 2024; 16:178. [PMID: 38668603 PMCID: PMC11054793 DOI: 10.3390/toxins16040178] [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: 03/06/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Chronic migraine (CM) is a disabling and hard-to-treat condition, associated with high disability and high cost. Among the preventive treatments, botulinum toxin A (BoNT-a) and monoclonal antibodies against the calcitonin gene-related protein (anti-CGRP mAbs) are the only disease-specific ones. The assessment of the disease burden is complex, and among others, tools such as the allodynia symptoms checklist (ASC-12) and headache impact test (HIT-6) are very useful. This exploratory study analysed the impact of these two therapies on migraine burden. METHODS The RAMO study was a multicentre, observational, retrospective investigation conducted in two headache centres: the Fondazione IRCCS Istituto Neurologico Carlo Besta (Milan) and the Fondazione Policlinico Campus Bio-Medico (Rome). This study involved patients with chronic migraine treated with mAbs or BoNT-A. We conducted a subgroup exploratory analysis on HIT-6 and ASC-12 scores in the two groups. The Wilcoxon rank-sum test, Fisher's exact test, and ANOVA were performed. RESULTS Of 126 patients, 36 on mAbs and 90 on BoNT-A had at least one available follow-up. mAbs resulted in a mean reduction of -11.1 and -11.4 points, respectively, in the HIT-6 at 6 and 12 months, while BoNT-A was reduced -3.2 and -3.6 points, respectively; the mAbs arm resulted in mean reductions in ASC-12 at 6 and 12 months of follow-up of -5.2 and -6.0 points, respectively, while BoNT-A showed lesser mean changes of -0.5 and -0.9 points, respectively. The adjusted analysis confirmed our results. CONCLUSIONS In this exploratory analysis, anti-CGRP mAbs showed superior effectiveness for HIT-6 and ASC12 compared to BoNT-A. Reductions in terms of month headache days (MHD), migraine disability assessment test (MIDAS), and migraine acute medications (MAM) were clinically relevant for both treatments.
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Affiliation(s)
- Danilo Antonio Montisano
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133 Milan, Italy
| | - Riccardo Giossi
- Poison Control Center and Clinical Pharmacology Unit, Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
- Department of Research and Clinical Development, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133 Milan, Italy
| | - Mattia Canella
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, Università degli Studi di Milano, Via Vanvitelli, 32, 20129 Milan, Italy
- Neuroimmunology and Neuromuscular Disease Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
| | - Claudia Altamura
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Marilena Marcosano
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Fabrizio Vernieri
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20131 Milan, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria, 11, 20133 Milan, Italy
- SC Neuroalgologia–Centro Cefalee, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
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Marusich T, Szikszay TM, Sennholz A, Luedtke K, Carvalho GF. Translation, cross-cultural adaptation and measurement proprieties of the German version of the Allodynia Symptom Checklist (ASC-12). J Headache Pain 2023; 24:160. [PMID: 38041009 PMCID: PMC10693116 DOI: 10.1186/s10194-023-01697-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Cutaneous allodynia is highly prevalent among migraineurs and is associated with a poor prognosis. The Allodynia Symptom Checklist (ASC-12) is a comprehensive questionnaire to identify the presence and severity of allodynia. Our aim was to translate and adapt the ASC-12 to German and evaluate its measurement properties. METHODS Following the COSMIN guidelines, 80 migraine patients were enrolled in the study to evaluate the stages of translation (n=30) and measurement propriety assessment (n=50), respectively. After reaching a final version, the German ASC-12 was assessed for structural validity, internal consistency, test-retest reliability, construct validity and absolute agreement, using mechanical and thermal pain thresholds as reference method. RESULTS The German version of the ASC-12 presented an adequate structural validity compatible with the original version of the questionnaire. Its internal consistency ranged from 0.70 to 0.80 considering the total score and the thermic, static and dynamic mechanic subdomains. The total score presented excellent reliability (ICC: 0.85) with a standard error of measurement of 1.15 points and smallest detectable change of 3.40 points. ASC-12 total scores were correlated with headache intensity (r=0.38, p=0.004), headache disability (r=0.37, p=0.004) and cold pain thresholds (r=0.28, p=0.025). The thermic allodynia ASC-12 scores were correlated with cold (r=0.36, p=0.005) and heat (r=-0.30, p=0.010) pain thresholds, while the static mechanical allodynia ASC-12 scores correlated with mechanical pain threshold (r=0.29, p=0.019) and with mechanical pain sensitivity (r=0.24 to 0.28, p< 0.045). Despite no significant bias between methods, quantitative sensory testing (QST) results and ASC-12 scores tend to disagree. CONCLUSION The German version of the ASC-12 is available for research and clinical settings and presented adequate measurement proprieties, as the original version. Despite the correlation between the ASC-12 and QST, one method cannot be replaced by the other.
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Affiliation(s)
- Tetiana Marusich
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Deutschland
| | - Tibor M Szikszay
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Deutschland
| | - Anne Sennholz
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Deutschland
| | - Kerstin Luedtke
- Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Deutschland.
| | - Gabriela F Carvalho
- Department of Physiotherapy, Faculty of Health, Safety and Society, Furtwangen University, Furtwangen, Germany
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Vitali-Silva A, Vuolo IG, Gonzalez LH, Galvão RF, Farges SG, Bello VA, Poli-Frederico RC. Oral combined hormonal contraceptive associated with protection against allodynia in migraine in a cross-sectional study. Ir J Med Sci 2023; 192:2203-2208. [PMID: 36720786 DOI: 10.1007/s11845-023-03293-x] [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: 09/04/2022] [Accepted: 01/24/2023] [Indexed: 02/02/2023]
Abstract
INTRODUCTION For the most part, migraine afflicts young women who often need to use the hormonal contraceptive method. OBJECTIVE To evaluate the effects of using exogenous estrogen, present in combined hormonal contraceptives (CHC) and progestin-only methods on the prevalence of allodynia in women with migraine. METHODS Study comprising women diagnosed with migraine, with or without aura, who were not pregnant, breastfeeding, or menopausal. The study was conducted via the digital platform. Data were collected relating to demographics, contraceptive method, anthropometric information, smoking habits, and migraine-related symptoms. The participants then answered the following validated, self-administered questionnaires: Migraine Disability Assessment (MIDAS), Allodynia Symptom Checklist, Generalized Anxiety Disorder (GAD-7), and Beck's Depression Inventory (BDI). In order to determine the variables associated with allodynia, two binary logistic regression models were used. RESULTS Four hundred eighty-six women took part in the study. Of these, 205 used CHC, 89 used a progestin-only method, and 192 participants did not use any form of hormonal contraception. Allodynia was identified in 411 (84.6%) participants. Allodynia was linked to the presence of aura (OR = 2.76; CI 95% 1.55-4.91; p = 0.001), menstrually related migraine (OR = 2.14; CI 95% 1.28-3.57; p = 0.004), greater disability (MIDAS score 23 vs. 8; p < 0.001), depression (BDI score 14 vs. 10; p < 0.001), and anxiety (GAD-7 score 11 vs. 8; p < 0.001). In adjusted analysis, CHC was associated to protection against allodynia when jointly evaluated all CHC regimens (OR = 0.49 CI 95% 0.26-0.92; p = 0.028), as well as oral CHC individually (OR = 0.48 CI 95% 0.25-0.92; p = 0.027). CONCLUSION CHC reduced the chances of women with migraine getting allodynia.
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Affiliation(s)
- Aline Vitali-Silva
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil.
| | - Isabella G Vuolo
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil
| | - Lara H Gonzalez
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil
| | - Renata F Galvão
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil
| | - Silvia G Farges
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil
| | - Valéria A Bello
- Medical School, Pontifical Catholic University of Paraná, Londrina-PR, Brazil
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Martinelli D, Pocora MM, De Icco R, Allena M, Vaghi G, Sances G, Castellazzi G, Tassorelli C. Searching for the Predictors of Response to BoNT-A in Migraine Using Machine Learning Approaches. Toxins (Basel) 2023; 15:364. [PMID: 37368665 DOI: 10.3390/toxins15060364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
OnabotulinumtoxinA (BonT-A) reduces migraine frequency in a considerable portion of patients with migraine. So far, predictive characteristics of response are lacking. Here, we applied machine learning (ML) algorithms to identify clinical characteristics able to predict treatment response. We collected demographic and clinical data of patients with chronic migraine (CM) or high-frequency episodic migraine (HFEM) treated with BoNT-A at our clinic in the last 5 years. Patients received BoNT-A according to the PREEMPT (Phase III Research Evaluating Migraine Prophylaxis Therapy) paradigm and were classified according to the monthly migraine days reduction in the 12 weeks after the fourth BoNT-A cycle, as compared to baseline. Data were used as input features to run ML algorithms. Of the 212 patients enrolled, 35 qualified as excellent responders to BoNT-A administration and 38 as nonresponders. None of the anamnestic characteristics were able to discriminate responders from nonresponders in the CM group. Nevertheless, a pattern of four features (age at onset of migraine, opioid use, anxiety subscore at the hospital anxiety and depression scale (HADS-a) and Migraine Disability Assessment (MIDAS) score correctly predicted response in HFEM. Our findings suggest that routine anamnestic features acquired in real-life settings cannot accurately predict BoNT-A response in migraine and call for a more complex modality of patient profiling.
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Affiliation(s)
- Daniele Martinelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Maria Magdalena Pocora
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Marta Allena
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Gloria Vaghi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Gloria Castellazzi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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Rossi DM, de Souza HCD, Bevilaqua-Grossi D, Vendramim ACC, Philbois SV, Carvalho GF, Dach F, Mascarenhas S, de Oliveira AS. Impairment on Cardiovascular Autonomic Modulation in Women with Migraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:763. [PMID: 36613082 PMCID: PMC9819790 DOI: 10.3390/ijerph20010763] [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: 10/21/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Autonomic dysfunction, such as reduced vagally mediated heart rate variability, has been suggested in headache patients but is still uncertain when considering primary headache disorders. This study aims to compare the heart rate and blood pressure variability and baroreflex sensitivity between women with migraine and controls. A migraine (n = 20) and a control group (n = 20) of age-matched women without headache were evaluated. Heart rate variability was analyzed through frequency-domain using spectral analysis presenting variance, low-frequency (LF; 0.04-0.15 Hz) and high-frequency (HF; 0.15-0.4 Hz) bands and by time domain (root mean square of successive R-R interval differences, RMSSD). Blood pressure variability was analyzed with spectral analysis and baroreflex sensitivity with the sequence method. Migraine group had lower heart rate variability characterized by a reduction in total variance, LF oscillations (sympathetic/vagal modulation) and HF oscillations (vagal modulation), and a reduction in SD and RMSSD compared to control group. No difference was found in the blood pressure variability analysis. Regarding baroreflex sensitivity, migraine group had decreased values of total gain, gain down and up compared to control group. Women with migraine exhibited autonomic modulation alterations, expressed by decreased values of heart rate variability and baroreflex sensitivity, but not by differences in blood pressure variability.
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Affiliation(s)
- Denise Martineli Rossi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba 38025-180, MG, Brazil
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Hugo Celso Dutra de Souza
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Ana Carolina Carmona Vendramim
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Stella Vieira Philbois
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | | | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
| | - Sérgio Mascarenhas
- São Carlos Institute of Physics, University of São Paulo, Sao Carlos 13566-590, SP, Brazil
| | - Anamaria Siriani de Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto 14049-900, SP, Brazil
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Wang Q, Ma T, Lu Z, Liu M, Wang L, Zhao S, Zhao Y. Xiongzhi Dilong decoction interferes with calcitonin gene-related peptide (CGRP)-induced migraine in rats through the CGRP/iNOS pathway. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Benatto MT, Florencio LL, Bragatto MM, Dach F, Fernández-de-las-Peñas C, Bevilaqua-Grossi D. Neck-specific strengthening exercise compared with placebo sham ultrasound in patients with migraine: a randomized controlled trial. BMC Neurol 2022; 22:126. [PMID: 35366822 PMCID: PMC8976325 DOI: 10.1186/s12883-022-02650-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/21/2022] [Indexed: 01/18/2023] Open
Abstract
Background Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervical muscle-strengthening exercise (CMSE) in reducing the frequency and intensity of headache in migraine patients. Methods A two-armed, parallel-group randomized controlled trial with a 3-month follow-up was performed. For eight weeks, the volunteers in the intervention group (n = 21) performed a protocol of CMSE, while those in the sham ultrasound group (n = 21) received the application of disconnected therapeutic ultrasound in the upper trapezius and guideline for home-stretching. The primary outcomes were the frequency and intensity of the headache. The secondary outcomes were questionnaires about migraine and neck disability, and satisfaction with the treatment, cervical range of motion, the pressure pain threshold, craniocervical flexion test (CCFT), cervical muscle strength and endurance test, and the cervical muscle activity during the physical tests. Results No differences were observed for the changes observed in primary outcomes after eight weeks and at the 3-months follow up (p > 0.05). For the secondary outcomes, craniocervical exercises improved the sensitivity of the frontal muscle (p = 0.040) and promoted a reduced amplitude of muscle activity of the anterior scalene and upper trapezius in the last stages of CCFT (p ≤ 0.010). There was also reduced muscle activity of the anterior scalene and splenius capitis in the endurance test (p ≤ 0.045), as evaluated by surface electromyography. Conclusion CMSE were insufficient in reducing the frequency and intensity of headache, improving the performance of the cervical muscles, or reducing migraine and neck pain-related disabilities. This was found despite a decreased electromyographic activity of the cervical muscles during the last stages of CCFT and increased median frequency during the endurance test. Trial registration Accession code RBR-8gfv5j, registered 28/11/2016 in the Registro Brasileiro de Ensaios Clínicos (ReBEC). Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02650-0.
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Utiumi MAT, Küster JGB, Godk KS, Santos MLD, Tan BC, Mioto E, Kotsifas NJE, Canalli Filho LC, Colombani GEF, Kowacs PA, Piovesan EJ. Prevalence of trigeminocervical convergence mechanisms in episodic and chronic migraine. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:482-489. [PMID: 35239801 DOI: 10.1590/0004-282x-anp-2021-0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/31/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Migraine pain location and trigeminocervical convergence have limited diagnostic value and have usually been assessed using non-standard verbal descriptors in a small number of centers. OBJECTIVE To use non-verbal descriptors of migraine pain location to determine the prevalence of trigeminocervical convergence mechanisms in patients with episodic and chronic migraine. In addition, we explored the factors associated with the presence of convergence. METHODS A multicenter study was carried out. The explicit pain location was explored by asking subjects to indicate, on an electronic form, three points on the anterolateral side and three points on the posterolateral side of the head and neck that represented the common locations of their migraine pain. We evaluated associations of the pain pattern with demographic and psychological features, comorbidities, lifestyle and other headache characteristics. RESULTS 97 episodic and 113 chronic migraine patients were included. Convergence was present in 116 migraineurs (55%) who indicated dominance of pain in the posterior cervical region. This site was more often involved in the chronic migraine group (21 vs. 33%; p=0.034). The number of migrainous/altered sensitivity symptoms (OR=1.39; 95%CI 1.14-1.71) was associated with convergence independently of the chronification status. In this symptom group, there were statistical associations between convergence and vomiting (p=0.045), tactile allodynia (p<0.001), nuchal rigidity (p<0.001) and movement allodynia (p=0.031). CONCLUSIONS Trigeminocervical convergence is common in migraineurs and, in practice, it might be found frequently in chronic migraineurs. Some features commonly found in this group, such as altered sensitivity symptoms, are associated with this phenomenon.
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Affiliation(s)
- Marco Antonio Takashi Utiumi
- Universidade Federal do Paraná, Hospital de Clínicas, Programa de Pós-Graduação em Medicina Interna, Departamento de Clínica Médica, Curitiba PR, Brazil.,Clínica de Neurologia São José, São José dos Pinhais PR, Brazil.,Hospital Marcelino Champagnat, Serviço de Neurologia, Curitiba PR, Brazil
| | | | - Keryn Sporh Godk
- Universidade Federal do Paraná, Curso de Medicina, Setor de Ciências da Saúde, Curitiba PR, Brazil
| | - Maria Luiza Dos Santos
- Universidade Federal do Paraná, Curso de Medicina, Setor de Ciências da Saúde, Curitiba PR, Brazil
| | - Bin Cheng Tan
- Universidade Federal do Paraná, Curso de Medicina, Setor de Ciências da Saúde, Curitiba PR, Brazil
| | - Eldislei Mioto
- Universidade Federal do Paraná, Curso de Medicina, Setor de Ciências da Saúde, Curitiba PR, Brazil
| | | | | | | | - Pedro André Kowacs
- Universidade Federal do Paraná, Hospital de Clínicas, Programa de Pós-Graduação em Medicina Interna, Departamento de Clínica Médica, Curitiba PR, Brazil
| | - Elcio Juliato Piovesan
- Universidade Federal do Paraná, Hospital de Clínicas, Programa de Pós-Graduação em Medicina Interna, Departamento de Clínica Médica, Curitiba PR, Brazil.,Clínica de Neurologia São José, São José dos Pinhais PR, Brazil
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Rossi DM, Bevilaqua-Grossi D, Mascarenhas S, de Souza HCD, Carvalho GF, Vendramim ACC, Philbois SV, Dach F, Tallarico FJ, de Oliveira AS. Noninvasive intracranial pressure monitoring in women with migraine. Sci Rep 2022; 12:2635. [PMID: 35173207 PMCID: PMC8850543 DOI: 10.1038/s41598-022-06258-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
This cross-sectional study aimed to compare the waveform morphology through noninvasive intracranial pressure (ICP-NI) measurement between patients with migraine and controls, and to analyze the association with clinical variables. Twenty-nine women with migraine, age 32.4 (11.2) years and headache frequency of 12.6 (7.5) days per month and twenty-nine women without headache, age 32.1 (9.0) years, were evaluated. Pain intensity, migraine disability, allodynia, pain catastrophizing, central sensitization and depression were evaluated. The ICP-NI monitoring was performed by a valid method consisting of an extracranial deformation sensor positioned in the patients’ scalp, which allowed registration of intracranial pressure waveforms. Heart rate and blood pressure measurements were simultaneously recorded during 20 min in the supine position. The analyzed parameter was the P2/P1 ratio based on mean pulse per minute which P1 represents the percussion wave related to the arterial blood pression maximum and P2 the tidal wave, middle point between the P1 maximum and the dicrotic notch. There was no between-groups difference in the P2/P1 ratio (mean difference: 0.04, IC95%: -0.07 to 0.16, p = 0.352, F (1,1) = 0.881) adjusted by body mass index covariable. The Multiple Linear Regression showed non-statistical significance [F (5,44) = 1.104; p = 0.372; R2 = 0.11)] between the P2/P1 ratio and body mass index, presence of migraine, central sensitization, pain catastrophizing and depression. We found no correlation (p > 0.05) between P2/P1 ratio and migraine frequency, migraine onset, pain intensity, pain intensity at day of examination, disability, allodynia. Migraine patients did not present alterations in the waveform morphology through ICP-NI compared to women without headache and no association with clinical variables was found.
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Affiliation(s)
- Denise Martineli Rossi
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Débora Bevilaqua-Grossi
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Sérgio Mascarenhas
- São Carlos Institute of Physics, University of São Paulo, São Carlos, Brazil
| | - Hugo Celso Dutra de Souza
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Ferreira Carvalho
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Institut für Gesundheitswissenschaften, Studiengang Physiotherapie, Pain and Exercise Research Luebeck (P.E.R.L), Universität zu Lübeck, Lübeck, Germany
| | - Ana Carolina Carmona Vendramim
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Stella Vieira Philbois
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Anamaria Siriani de Oliveira
- Ribeirão Preto Medical School, Department of Health Sciences, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Florencio LL, de Oliveira AS, Pinheiro CF, Will-Lemos T, Dach F, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D. Comparison of cervical muscle isometric force between migraine subgroups or migraine-associated neck pain: a controlled study. Sci Rep 2021; 11:15434. [PMID: 34326451 PMCID: PMC8322422 DOI: 10.1038/s41598-021-95078-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022] Open
Abstract
This study aimed to verify if migraine frequency or migraine-associated neck pain were associated with a reduction of normalized force and altered electromyographic activity during maximal cervical muscle isometric contractions. Additionally, it aimed to assess the correlation of normalized isometric force with years with migraine, headache frequency, headache intensity, migraine-related disability, and severity of cutaneous allodynia. The sample comprises 71 women with migraine (40/31 episodic/chronic, 42/18 with/without neck pain) and 32 women without headache. Cervical muscle isometric force in flexion, extension, and lateral flexion was assessed synchronized with the acquisition of superficial electromyography from the cervical muscles. Women with episodic migraine presented lower normalized isometric force in extension, flexion, and right and left lateral flexions than controls (P < 0.05). Women with migraine and neck pain exhibited lower cervical extension and right/left lateral-flexions normalized isometric force than controls (P < 0.05). No significant differences were observed in antagonist activity. Normalized isometric force in all directions showed weak to moderate correlations with the severity of self-reported symptoms of cutaneous allodynia (- 0.25 ≥ r ≥ - 0.39). No additional linear correlation with clinical migraine features was observed. In conclusion, cervical muscle weakness may be associated with episodic migraine and neck pain concurrent with migraine attacks without altered antagonist activity. Additionally, it may also be related to the severity of cutaneous allodynia.
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Affiliation(s)
- Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madri, Spain. .,Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil.
| | - Anamaria Siriani de Oliveira
- Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil
| | - Carina Ferreira Pinheiro
- Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil
| | - Tenysson Will-Lemos
- Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922, Madri, Spain
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, 14049-900, Brazil.
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12
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de Almeida Tolentino G, Lima Florencio L, Ferreira Pinheiro C, Dach F, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D. Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol 2021; 21:249. [PMID: 34187384 PMCID: PMC8240357 DOI: 10.1186/s12883-021-02290-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Non-pharmacological approaches for the management of migraine exhibit low to moderate effectiveness due to a lack of high-quality randomized clinical trials. In fact, previous studies applied isolated techniques, which were not representative of common clinical practice. A multimodal approach for migraine may benefit these patients more than isolated approaches. This randomized clinical trial aims to determine the effectiveness of a multimodal protocol combining manual therapy, exercise, and therapeutic pain neuroscience education versus the application of manual therapy or pain neuroscience education alone in patients with migraine. Methods This clinical trial will include 75 individuals of both sexes, aged between 18 and 55 years, with migraine. Participants will be randomized into three groups: the therapeutic pain neuroscience education (TPNE; n = 25) group, the manual therapy (MT; n = 25) group, and the multimodal (MM; n = 25) group. The TPNE group will receive one orientation session on migraine and pain self-management, and recommendations for daily active stretching and walking, with subsequent therapist monitoring. The MT group will receive manual therapies targeting musculoskeletal disorders of the cervical spine. The MM group will receive manual therapies targeting musculoskeletal disorders of the cervical spine, active neck exercises, and therapeutic pain neuroscience education. The treatment period will last 12 weeks. The primary outcome will be the headache impact, measured using the Headache Impact Test (HIT-6). Secondary outcomes will include migraine frequency and intensity, cervical mobility and strength parameters, neck pain-related disability, kinesiophobia, cutaneous allodynia, pain-related catastrophizing, quality of life, and self-perception of change. All outcomes will be evaluated at the fourth, eighth, and twelfth weeks of the treatment period. Primary and secondary clinical outcomes, such as headache impact, frequency, and intensity, will also be evaluated at the 1-, 2-, and 4-month follow-ups. Discussion The results of this randomized clinical trial may provide high-quality clinical evidence of the effects of non-pharmacological treatment options for the management of migraine. Trial registration This study was registered under the access code RBR-7s22c75 in the Registro Brasileiro de Ensaios Clínicos (ReBEC) in December 2020.
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Affiliation(s)
- Gabriella de Almeida Tolentino
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Carina Ferreira Pinheiro
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
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13
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Ifesemen OS, McWilliams DF, Ferguson E, Wakefield R, Akin-Akinyosoye K, Wilson D, Platts D, Ledbury S, Walsh DA. Central Aspects of Pain in Rheumatoid Arthritis (CAP-RA): protocol for a prospective observational study. BMC Rheumatol 2021; 5:23. [PMID: 34162435 PMCID: PMC8223274 DOI: 10.1186/s41927-021-00187-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pain and fatigue are persistent problems in people with rheumatoid arthritis. Central sensitisation (CS) may contribute to pain and fatigue, even when treatment has controlled inflammatory disease. This study aims to validate a self-report 8-item questionnaire, the Central Aspects of Pain in Rheumatoid Arthritis (CAP-RA) questionnaire, developed to measure central pain mechanisms in RA, and to predict patient outcomes and response to treatment. A secondary objective is to explore mechanisms linking CS, pain and fatigue in people with RA. METHODS/DESIGN This is a prospective observational cohort study recruiting 250 adults with active RA in secondary care. The CAP-RA questionnaire, demographic data, medical history, and patient reported outcome measures (PROMs) of traits associated with central sensitization will be collected using validated questionnaires. Quantitative sensory testing modalities of pressure pain detection thresholds, temporal summation and conditioned pain modulation will be indices of central sensitization, and blood markers, swollen joints and ultrasound scans will be indices of inflammation. Primary data collection will be at baseline and 12 weeks. The test-retest reliability of CAP-RA questionnaire will be determined 1 week after the baseline visit. Pain and fatigue data will be collected weekly via text messages for 12 weeks. CAP-RA psychometric properties, and predictive validity for outcomes at 3 months will be evaluated. DISCUSSION This study will validate a simple self-report questionnaire against psychophysical indices of central sensitization and patient reported outcome measures of traits associated with CS in a population of individuals with active RA. The application of this instrument in the clinical environment could provide a mechanism-based stratification tool to facilitate the provision of targeted therapy to individuals with pain and fatigue in RA, alongside treatments that target joint inflammation. TRIAL REGISTRATION Clinicaltrials.gov NCT04515589 . Date of registration 17 August 2020.
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Affiliation(s)
- Onosi S Ifesemen
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.
| | - Daniel F McWilliams
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Eamonn Ferguson
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Richard Wakefield
- Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Leeds Biomedical Research Centre, University of Leeds, and Leeds NHS Teaching Hospitals Trust, Leeds, UK
| | - Kehinde Akin-Akinyosoye
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Deborah Wilson
- Rheumatology, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in -Ashfield, Nottinghamshire, UK
| | | | | | - David A Walsh
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
- Rheumatology, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in -Ashfield, Nottinghamshire, UK
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14
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Xavier NDS, Benatto MT, Florencio LL, Fernández-de-Las-Peñas C, Dach F, Bevilaqua-Grossi D. Are there gender differences in neck pain and musculoskeletal disorders of the cervical spine associated with migraine? PAIN MEDICINE 2021; 22:3021-3029. [PMID: 33739397 DOI: 10.1093/pm/pnab106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate gender differences in clinical characteristics of migraine by examining presence and severity of cutaneous allodynia, migraine-related disability, neck pain and its associated disability, passive mobility of the upper cervical spine, and performance of the deep neck flexor muscles. DESIGN cross-sectional study. SUBJECTS 30 men and 30 women with migraine. METHODS Participants responded to the questionnaires Migraine Disability Assessment questionnaire, 12-item Allodynia Symptom Checklist and Neck Disability Index. The mobility of the upper cervical spine was assessed by using the Flexion-Rotation Test. Performance of the deep neck flexor muscles was evaluated by applying the Craniocervical Flexion Test. Comparison of the groups was carried out by using the Student's t-test or the chi-square test. The prevalence ratio was also calculated. RESULTS Women showed a higher prevalence of cutaneous allodynia (p = 0.001) and a 4 times greater risk of having severe cutaneous allodynia than to men (p = 0.007). No gender differences were observed in migraine-related disability (p = 0.08). Women showed higher prevalence of self-reported neck pain (p = 0.03) and increased risk of having this symptom in comparison to men (Prevalence Ratio=1.69; p = 0.025). However, there were no gender differences in neck pain-related disability (p = 0.25), mobility of the upper cervical spine (p = 0.92), or performance of the deep neck flexor muscles (p = 0.52). CONCLUSION Women with migraine had a higher frequency of self-reported neck pain and higher prevalence and severity of cutaneous allodynia when compared to men. However, the two groups did not differ regarding neck pain-related disability and performance in the physical tests.
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Affiliation(s)
- Nathan da Silva Xavier
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Mariana Tedeschi Benatto
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine - Universidad Rey Juan Carlos, Alcorcón, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine - Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Fabiola Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto-SP, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto-SP, Brazil
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15
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Prevalence and characteristics of cutaneous allodynia in probable migraine. Sci Rep 2021; 11:2467. [PMID: 33510340 PMCID: PMC7844001 DOI: 10.1038/s41598-021-82080-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/15/2021] [Indexed: 12/31/2022] Open
Abstract
Cutaneous allodynia (CA) is a pain in response to non-nociceptive stimulation and a marker of central sensitisation. Probable migraine (PM) is a migraine subtype that fulfils all but one criterion of migraine. Headache intensity and the disability of individuals with PM are similar or lower than individuals with migraine. This study compared CA prevalence and characteristics of PM and migraine using a nationally representative sample in Korea. The Allodynia Symptom Checklist-12 (ASC-12) was used to assess CA (ASC-12 score ≥ 3). PM and migraine prevalence were 11.6% and 5.0%, respectively. CA prevalence did not significantly differ between PM and migraine (14.5% vs. 16.0%, p = 0.701). Participants with PM with CA reported a higher monthly headache frequency (3.3 ± 4.3 vs. 1.8 ± 3.6, p = 0.044), more severe headache intensity (Visuals Analogue Scale, 6.0 [4.0–7.0] vs. 5.0 [3.0–6.0], p = 0.002), and higher impact of headache (Headache Impact Test-6, 56.3 ± 7.2 vs. 48.3 ± 8.0, p < 0.001) than those without CA. Multiple regression analyses revealed that headache frequency and intensity, anxiety, and depression were significant factors for CA in participants with PM. In conclusion, CA prevalence among participants with PM and migraine were comparable. Anxiety, depression, and headache frequency and intensity were significant factors for CA in participants with PM.
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16
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Benatto MT, Florencio LL, Bragatto MM, Dach F, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D. Neck-specific strengthening exercise compared with sham ultrasound when added to home-stretching exercise in patients with migraine: study protocol of a two-armed, parallel-groups randomized controlled trial. Chiropr Man Therap 2020; 28:22. [PMID: 32423454 PMCID: PMC7236100 DOI: 10.1186/s12998-020-00313-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/16/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Migraine is a highly disabling condition and pharmacological treatment is the gold standard. However, several patients have also positive responses to the application of different manual techniques and therapeutic exercises in terms of reducing the intensity and frequency of migraine attacks. Nevertheless, the effects of a neck-specific exercise program have not yet been evaluated in these patients. OBJECTIVE To determine the effectiveness of a neck-specific exercise program in reducing the intensity and frequency of migraine attacks as compared to a sham ultrasound group. METHODS A two-armed, parallel-groups randomized controlled trial with 3 months of follow-up will be conducted. 42 individuals, both genders, aged between 18 and 55 years old with a medical diagnosis of migraine will be included. The intervention group will perform a protocol consisting of exercises for strengthening the muscles of the cervical spine. Participants within the sham ultrasound group will receive detuned ultrasound therapy in the upper trapezius muscle. Both groups will receive a weekly session for 8 weeks. The efficacy of each intervention will be measured by the frequency and intensity of migraine at a 3-months follow-up. TRIAL REGISTRATION This study was registered under access code RBT-8gfv5j in the Registro Brasileiro de Ensaios Clínicos (ReBEC) in November 28, 2016. CONCLUSION This study will aim to determine the efficacy of a neck-specific exercise program in reducing the frequency and intensity of migraine attacks. If the results show that a neck-specific exercise program is effective in reducing the frequency and intensity of migraine attacks, therapists will have a low cost and easily applicable tool to treat migraine.
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Affiliation(s)
- Mariana Tedeschi Benatto
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Marcela Mendes Bragatto
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
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17
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Kim SK, Chong CD, Dumkrieger G, Ross K, Berisha V, Schwedt TJ. Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine. J Headache Pain 2020; 21:33. [PMID: 32295535 PMCID: PMC7161138 DOI: 10.1186/s10194-020-01103-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. METHODS In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher's test and one-way ANOVA or Tukey's Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. RESULTS Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) (p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho (ρ) = 0.634, p < 0.01), followed by Trait Anxiety (ρ = 0.522, p < 0.01), PTSD (ρ = 0.505, p < 0.01), HQ (ρ = 0.469, p < 0.01), State Anxiety (ρ = 0.437, p < 0.01), and MIDAS scores (ρ = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. CONCLUSIONS Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.
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Affiliation(s)
- Soo-Kyoung Kim
- Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, South Korea.,Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | - Catherine D Chong
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | - Gina Dumkrieger
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA
| | | | | | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
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18
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Melhado EM, Thiers Rister HL, Galego DR, de Oliveira AB, Buttarello IA, Belucio IS, Oliveira Marcos JM, Xavier MLT, Peres MFP. Allodynia in Menstrually Related Migraine: Score Assessment by Allodynia Symptom Checklist (ASC-12). Headache 2019; 60:162-170. [PMID: 31637701 DOI: 10.1111/head.13677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to compare the allodynia score in headache attacks related and not related to menstruation in women diagnosed with menstrually related migraine without aura. BACKGROUND Allodynia is an important symptom in migraine and has been associated with migraine chronification. No study has yet compared prospectively allodynia in menstrual vs non-menstrual attacks within the same cohort of patients. METHODS This is a prospective cohort study, where participants had the 12-item Allodynia Symptom Checklist (ASC-12) assessed after 1, 2, 4, and 24 hours from the onset of migraine attacks in 2 different conditions, with menstrual migraine attack (MM+) and with non-menstrual migraine attack (MM-). RESULTS A total of 600 women with headache complaints were screened from March 2013 to July 2014 in a headache outpatient or headache tertiary clinic. From these, 55 participants were recruited, and 32 completed the study. Participants' mean age was 27 years, BMI was 22.1, menarche age 12 years, migraine history was 11.5 years, and most women were young (ranged from 17 to 44 years of age), were in higher school (13/32 = 41%), single (20/32 = 63%), and used contraceptives (22/32 = 69%). Multiple pairwise comparisons of ANCOVA's test showed significant higher ASC-12 scores in MM+ group compared to MM- group at 2 hours [mean, 95% CI of difference: 2.3 (0.31, 4.7), P = .049)]. For the ASC-12 categorical scores (absent, mild, moderate, and severe) MM+ yielded higher scores than MM- at 1 hour (z = -3.08, P = .021) and 4 hours (z = -2.97, P = .03). CONCLUSION This study demonstrated that in the patents from tertiary headache center assessed, menstrual-related migraine attacks augment allodynia scores in the beginning of attacks compared to non-menstrual migraine attacks.
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Affiliation(s)
- Eliana Meire Melhado
- Department of Neurology, Padre Albino University Center Medical School, Catanduva, Brazil
| | | | - Débora Renata Galego
- Department of Neurology, Padre Albino University Center Medical School, Catanduva, Brazil
| | | | | | - Inaê Silveira Belucio
- Department of Neurology, Padre Albino University Center Medical School, Catanduva, Brazil
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Benatto MT, Bevilaqua-Grossi D, Carvalho GF, Bragatto MM, Pinheiro CF, Straceri Lodovichi S, Dach F, Fernández-de-Las-Peñas C, Florencio LL. Kinesiophobia Is Associated with Migraine. PAIN MEDICINE 2019; 20:846-851. [PMID: 30462312 DOI: 10.1093/pm/pny206] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to assess kinesiophobia in patients with migraine and to determine its association and correlation with cutaneous allodynia and clinical manifestations of migraine. DESIGN A cross-sectional study. SETTING A headache clinic of a university-based hospital. SUBJECTS Eighty-nine patients diagnosed with migraine by a neurologist specialized in headache. METHODS Patients completed the Tampa Scale for Kinesiophobia (TSK) and the 12-item Allodynia Symptom Checklist (ASC-12) and described the frequency, duration, and intensity of migraine attacks, as well as number of years with migraine. RESULTS The prevalence of kinesiophobia was 53%, and it was associated with the classification of severe cutaneous allodynia (X2= 9.96, P = 0.02) but not with its presence (X2= 3.11, P = 0.07). Kinesiophobia and clinical migraine features were not significantly associated (P > 0.05), nor were TSK score, ASC-12 score, or clinical migraine features (r < 0.21, P > 0.05). Subjects with migraine, with or without kinesiophobia, believed that physical activity could not help to control or relieve their pain, and those with kinesiophobia, furthermore, believed that exercise may be harmful. CONCLUSIONS Kinesiophobia is present in about half of migraineurs. It was associated with worsened cutaneous allodynia severity, but not with its presence, in patients with migraine. Education strategies should be implemented as negative beliefs related to exercise are present despite its evidence of benefit in migraine treatment.
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Affiliation(s)
| | | | | | | | | | | | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
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Extensor/flexor ratio of neck muscle strength and electromyographic activity of individuals with migraine: a cross-sectional study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 28:2311-2318. [PMID: 31399847 DOI: 10.1007/s00586-019-06097-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/06/2019] [Accepted: 08/04/2019] [Indexed: 12/23/2022]
Abstract
PURPOSE Neck pain is considered a common characteristic of migraine attacks. The relationship between neck pain and migraine can be explained by central sensitization of the trigeminocervical complex, where superior cervical afferents and the trigeminal nerve converge. However, few studies have evaluated motor control of cervical muscles in individuals with migraine. Thus, the purpose of the present study was to determine the extensor/flexor ratio of neck muscle strength and electromyographic activity during a test of maximal voluntary isometric contraction and craniocervical flexion in individuals with migraine and individuals without history of migraine or other headaches. METHODS Fifty-two women with the disease and 52 women with neither a history of migraine nor neck pain, between 18 and 55 years old, were included in the study. The electromyographic activities of the sternocleidomastoid, anterior scalene, splenius capitis, and upper trapezius muscles were evaluated during a test of maximal voluntary isometric contraction and craniocervical flexion. RESULTS The migraine group presented lower flexor muscle strength and a higher extensor/flexor muscle strength ratio than the control group. In addition, the migraine group showed a reduced electromyographic extensor/flexor muscle ratio during maximal voluntary isometric contraction in flexion. The results demonstrated worse performance in the craniocervical flexion test of the migraine group and a lower electromyographic ratio of extensor/flexor neck muscles in the last stage of the test. CONCLUSION Altogether, the migraine group presented an imbalance in cervical muscles verified not only during force production, but also during muscle activity. These slides can be retrieved under Electronic Supplementary Material.
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Concomitant Migraine and Temporomandibular Disorders are Associated With Higher Heat Pain Hyperalgesia and Cephalic Cutaneous Allodynia. Clin J Pain 2017; 32:882-8. [PMID: 26905569 DOI: 10.1097/ajp.0000000000000369] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to assess differences in the levels of hyperalgesia and cutaneous allodynia (CA) among women with migraine, temporomandibular disorders (TMD), or both. MATERIALS AND METHODS Eighty women participated in the study. Mean ages for the control group, TMD group, migraine group, and migraine+TMD group were 26.15 (95% confidence interval [CI], 28.73 to 23.57), 31.65 (95% CI, 37.82 to 25.48), 35.05 (95% CI, 40.37 to 29.73), and 34.20 (95% CI, 37.99 to 30.41) years, respectively. The 12-item Allodynia Symptom Checklist was administered to assess CA. All participants underwent the Quantitative Sensory Test to determine the cold-pain and heat-pain thresholds. Mechanical pain thresholds were assessed using Semmes-Weinstein monofilaments. One-way analysis of variance and χ tests were used for statistical analysis. Alpha was set at 0.05 level for statistical significance. RESULTS For all sites evaluated, the mean cold-pain threshold values were significantly lower in the TMD, migraine, and TMD+migraine groups compared with the control group. However, the mean heat-pain threshold values in the extracephalic region were significantly smaller only for the TMD+migraine group compared with the control group (41.94°C; 95% CI, 40.54 to 43.34 vs. 44.79°C; 95% CI, 43.45 to 46.12; P=0.03). Mechanical hyperalgesia in orofacial and neck sites was significantly lower in the TMD and TMD+migraine groups compared with the control group. Mean total 12-item Allodynia Symptom Checklist score in the TMD+migraine group was significantly higher than in the migraine group (9.53; 95% CI, 7.45 to 11.60 vs. 6.95; 95% CI, 5.35 to 8.55; P=0.02). CONCLUSIONS More pronounced levels of hyperalgesia and CA were found in patients with both TMD and migraine. Thus, it is suggested that the concomitant presence of TMD and migraine may be related to intensification of central sensitization.
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Yalin OÖ, Uludüz D, Sungur MA, Sart H, Özge A. Identification of Allodynic Migraine Patients with the Turkish Version of the Allodynia Symptom Checklist: Reliability and Consistency Study. ACTA ACUST UNITED AC 2017; 54:260-266. [PMID: 29033640 DOI: 10.5152/npa.2016.15953] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 03/07/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Cutaneous allodynia is regarded as an expression of central sensitization in migraine. Although the gold standard is quantitative sensory testing, several practical assessment questionnaires have been developed to assess allodynia in migraine. We aimed to establish the first valid Turkish allodynia assessment questionnaire based on a 12-item allodynia symptom checklist and to evaluate the associated factors. METHODS The first part of the study included the translation and cultural adaptation of a Turkish version of the checklist. The Turkish version of the questionnaire was administered to 344 episodic and chronic migraine patients, who were chosen according to the International Classification of Headache Disorders -III beta criteria. RESULTS The total checklist score showed excellent test-retest reliability (r=0.821). The internal consistency of the checklist was assessed using Cronbach alpha values and was found to be acceptable (Cronbach alpha for the checklist=0.767). Data analysis revealed that 10 items of the questionnaire adequately identified allodynic subjects. Cutaneous allodynia was present in 218 (63.4%) migraine patients. Allodynia was more prominent in patients experiencing migraine with aura (p=0.008) and in females (p<0.001). Multiple logistic regression analysis found that female gender, aura existence, longer headache duration, and higher attack frequency were the major determinants of cutaneous allodynia. CONCLUSION Allodynia is common and has clinical significance in migraine; therefore, establishing a validated Turkish questionnaire for the assessment of allodynia was necessary. In this study, a Turkish version of the allodynia symptom checklist was validated and found to be convenient for the identification of allodynia in migraine patients.
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Affiliation(s)
- Osman Özgür Yalin
- Clinic of Neurology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Derya Uludüz
- Department of Neurology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Mehmet Ali Sungur
- Department of Biostatistics, Düzce University School of Medicine, Düzce, Turkey
| | - Hande Sart
- Department of Educational Sciences, Boğaziçi University School of Education, İstanbul, Turkey
| | - Aynur Özge
- Department of Neurology, Mersin University School of Medicine, Mersin, Turkey
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Benatto MT, Florencio LL, Carvalho GF, Dach F, Bigal ME, Chaves TC, Bevilaqua-Grossi D. Cutaneous allodynia is more frequent in chronic migraine, and its presence and severity seems to be more associated with the duration of the disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:153-159. [DOI: 10.1590/0004-282x20170015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
ABSTRACT Objective To evaluate cutaneous allodynia among patients with chronic and episodic migraine in a tertiary headache clinic. Methods 80 subjects with episodic migraine and 80 with chronic migraine were assessed in a tertiary hospital. The 12-item Allodynia Symptom Checklist/Brazil questionnaire was applied to classify subjects according to the presence and severity of cutaneous allodynia. Results Cutaneous allodynia was identified in 81.3% of the episodic migraine group and 92.5% of the chronic migraine group (p = 0.03). No increased association could be attributed to chronic migraine when adjusted by years with disease (PR = 1.12; 95%CI = 0.99 to 1.27; p = 0.06). The groups also did not differ in the severity of allodynia, and severe presentation was the most frequent. Discussion Both groups seemed to be similarly affected in the cephalic and extracephalic regions, with the same severity. Conclusion Cutaneous allodynia is more frequent in chronic migraine, and its presence and severity seems to be more associated with the duration of the disease.
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Bevilaqua-Grossi D, Gonçalves MC, Carvalho GF, Florencio LL, Dach F, Speciali JG, Bigal ME, Chaves TC. Additional Effects of a Physical Therapy Protocol on Headache Frequency, Pressure Pain Threshold, and Improvement Perception in Patients With Migraine and Associated Neck Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil 2015; 97:866-74. [PMID: 26718237 DOI: 10.1016/j.apmr.2015.12.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/15/2015] [Accepted: 12/04/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the additional effect provided by physical therapy in migraine treatment. DESIGN Randomized controlled trial. SETTING Tertiary university-based hospital. PARTICIPANTS Among the 300 patients approached, 50 women (age range, 18-55y) diagnosed with migraine were randomized into 2 groups: a control group (n=25) and a physiotherapy plus medication group (n=25) (N=50). INTERVENTIONS Both groups received medication for migraine treatment. Additionally, physiotherapy plus medication patients received 8 sessions of physical therapy over 4 weeks, comprised mainly of manual therapy and stretching maneuvers lasting 50 minutes. MAIN OUTCOME MEASURES A blinded examiner assessed the clinical outcomes of headache frequency, intensity, and self-perception of global change and physical outcomes of pressure pain threshold and cervical range of motion. Data were recorded at baseline, posttreatment, and 1-month follow-up. RESULTS Twenty-three patients experienced side effects from the medication. Both groups reported a significantly reduced frequency of headaches; however, no differences were observed between groups (physiotherapy plus medication patients showed an additional 18% improvement at posttreatment and 12% improvement at follow-up compared with control patients, P>.05). The reduction observed in the physiotherapy plus medication patients was clinically relevant at posttreatment, whereas clinical relevance for control patients was demonstrated only at follow-up. For pain intensity, physiotherapy plus medication patients showed statistical evidence and clinical relevance with reduction posttreatment (P<.05). In addition, they showed better self-perception of global change than control patients (P<.05). The cervical muscle pressure pain threshold increased significantly in the physiotherapy plus medication patients and decreased in the control patients, but statistical differences between groups were observed only in the temporal area (P<.05). No differences were observed between groups regarding cervical range of motion. CONCLUSIONS We cannot assume that physical therapy promotes additional improvement in migraine treatment; however, it can increase the cervical pressure pain threshold, anticipate clinically relevant changes, and enhance patient satisfaction.
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Affiliation(s)
- Débora Bevilaqua-Grossi
- Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil.
| | | | - Gabriela Ferreira Carvalho
- Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Lidiane Lima Florencio
- Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - Fabíola Dach
- Ribeirao Preto Medical School, Department of Neuroscience and Behavioral Sciences, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - José Geraldo Speciali
- Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil
| | | | - Thaís Cristina Chaves
- Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil
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Belfort T, Bramham J, Simões Neto JP, Sousa MFBD, Santos RLD, Nogueira MML, Torres B, Rosa RDLD, Dourado MCN. Cross-cultural adaptation of the Social and Emotional Questionnaire on Dementia for the Brazilian population. SAO PAULO MED J 2015; 133:358-66. [PMID: 26517147 PMCID: PMC10876360 DOI: 10.1590/1516-3180.2014.00180501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 10/29/2014] [Accepted: 01/05/2015] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Impairments in social and emotional functioning may affect the communication skills and interpersonal relationships of people with dementia and their caregivers. This study had the aim of presenting the steps involved in the cross-cultural adaptation of the Social and Emotional Questionnaire (SEQ) for the Brazilian population. DESIGN AND SETTING Cross-cultural adaptation study, conducted at the Center for Alzheimer's Disease and Related Disorders in a public university. METHODS The process adopted in this study required six consecutive steps: initial translation, translation synthesis, back translation, committee of judges, pretesting of final version and submission to the original author. RESULTS In general, the items had semantic, idiomatic, conceptual and experiential equivalence. During the first pretest, people with dementia and their caregivers had difficulties in understanding some items relating to social skills, which were interpreted ambiguously. New changes were made to allow better adjustment to the target population and, following this, a new pretest was performed. This pre-test showed that the changes were relevant and gave rise to the final version of the instrument. There was no correlation between education level and performance in the questionnaire, among people with dementia (P = 0.951). CONCLUSION The Brazilian Portuguese version of the Social and Emotional Questionnaire was well understood and, despite the cultural and linguistic differences, the constructs of the original version were maintained.
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Affiliation(s)
- Tatiana Belfort
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jessica Bramham
- Clinical Neuropsychology, School of Psychology, University College Dublin, Dublin, Ireland
| | - José Pedro Simões Neto
- Department of Sociology and Political Science, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Maria Fernanda Barroso de Sousa
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel Luiza dos Santos
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcela Moreira Lima Nogueira
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Torres
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rachel Dias Lopes da Rosa
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Cristina Nascimento Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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