Headache characteristics and burden from chronic migraine with medication overuse headache: Cross‐sectional observations from the Medication Overuse Treatment Strategy trial

2021 ◽  
Author(s):  
Todd J. Schwedt ◽  
Joseph G. Hentz ◽  
Soma Sahai‐Srivastava ◽  
Nicole M. Spare ◽  
Vincent T. Martin ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Treatment Strategy ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Cross Sectional

Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache

Cephalalgia ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Song Guo ◽  
Sarvnaz Shalchian ◽  
Pascale Gérard ◽  
Michael Küper ◽  
Zaza Katsarava ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Transcranial Doppler ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Episodic Migraine ◽  
Severe Form ◽  
Cross Sectional ◽  
Headache Clinic ◽  
Chronic Headaches ◽  
Chronic Migraineurs

Background It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication-overuse headache (MOH), one may wonder if they have a more severe form of the disorder and more frequently a PFO. Objective The objective of this study is to determine the prevalence and grade of RLS in patients suffering from CM and MOH. Methods A cross-sectional multicenter study of air-contrast transcranial Doppler was conducted in 159 patients with CM ( n = 57) or MOH ( n = 102) attending a tertiary headache clinic. Results The prevalence of RLS in CM was 37% (11% large shunts) and in MOH patients 31% (13% large shunts). There was no difference between the two groups ( p = 0.49). Conclusion RLS prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches.

scholarly journals Cognitive Decline in Chronic Migraine with Nonsteroid Anti-inflammation Drug Overuse: A Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoying Cai ◽  
Xiaotian Xu ◽  
Aiwu Zhang ◽  
Jianwen Lin ◽  
Xiaojuan Wang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Life Quality ◽  
Executive Dysfunction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Background. Chronic migraine with medication overuse headache (CM-MOH) is the most common type of chronic migraine, and it increases risk of stroke and white matter lesions. These pathologic changes could induce cognitive decline. However, the alteration of cognitive function in CM-MOH patients is not established. Therefore, we took this study to reveal the cognitive performances in CM-MOH. Methods. This cross-sectional study was conducted between December 2015 and January 2017. Patients were divided into CM-MOH, CMwoMOH (chronic migraine without medication overuse), and MO (migraine without aura) groups. Cognitive function was assessed in all cases during interictal periods using Addenbrooke’s Cognitive Examination Test (ACE-R), Trail Making Test A/B (TMT A/B), and Digit Symbol Test (DST). Detailed headache characteristics and evaluation of anxiety, depression, and living and sleep quality were collected. Results. 116 patients were included in this study. There were 21 CM-MOHs, 20 CMwoMOHs, 35 MOs, and 40 controls. Age and education were the independent risk factors of cognitive decline (P<0.05). After adjusting, the risk of cognitive decline was higher in CM compared with control in ACE-R score and language fluency (P<0.05). In addition, CM-MOH sufferers were in higher risk of memory and executive dysfunction (P<0.05). The cognitive function had no difference between CM-MOH and CMwoMOH (P>0.05). Meanwhile, CM-MOH got significantly higher scores than MO in anxiety and depression, with poorer performances in sleep and life quality (P<0.05). Conclusion. The risk of cognitive decline increased in chronic migraine patients. Nonsteroid anti-inflammatory drugs overuse had no influence on cognitive performances among chronic migraine sufferers.

White matter lesions in chronic migraine with medication overuse headache: a cross-sectional MRI study

2014 ◽  
Vol 261 (4) ◽  
pp. 784-790 ◽  
Author(s):  
Zhenyang Zheng ◽  
Zijian Xiao ◽  
Xiaolei Shi ◽  
Minghui Ding ◽  
Wei Di ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
White Matter Lesions ◽  
Cross Sectional ◽  
Mri Study

scholarly journals Sociodemographic characteristics of patients with chronic headache

2020 ◽  
pp. 22-24
Author(s):  
Patrick Giordanni Gomes Sampaio ◽  
Hiago Diniz Maracajá ◽  
Sara Raquel Nóbrega Figueiredo ◽  
Virgínia Gabriela Nóbrega Figueiredo ◽  
Túlio Carneiro Monteiro Temoteo ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Interpersonal Relationships ◽  
Medical Records ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Cross Sectional Study ◽  
Secondary Headache ◽  
Cross Sectional ◽  
Number Of Patients

Introduction: Headache is an entity characterized by a painful process in the cephalic segment and may originate from cranial or facial structures, being considered a common medical complaint. The chronification process of the pain can present a decrease in quality, the functional capacity and the patient’s and labor environment, and also as well as affect their interpersonal relationships, since the chronic cephalalgic process can lead the patient to moments of social isolation, mood swings, depression. Methods: The research was conducted through a retrospective cross-sectional study, performing the analysis of medical records of patients seen at the Unifacisa’s outpatient neurology School Clinic complaining of chronic headache, from February 1st to August 31, 2019. Results: With the analysis of the medical records, 684 attendances were obtained, where 30 of the patients treated had the diagnosis of chronic headache, 29 women and 01 man. These patients received the following diagnoses: 18 (60%) patients with chronic migraine without aura, 4 (13.3%) patients with chronic migraine with aura, 12 (40%) patients with chronic daily medication overuse headache, 9 (30%) patients with chronic tensiontype headache (CTTH), 1 (3.3%) patient with basilar migraine, 2 (6.6%) patients with secondary headache. Conclusion: Although a small number of chronic headache patients were obtained, yet we realize that it is the migraine that leads to a greater demand for specialized medical care. In addition, as expected due to the latest research, a significant number of patients with headache due to excessive use of common painkillers.

scholarly journals Differences in Frontal Lobe Dysfunction in Patients with Episodic and Chronic Migraine

2021 ◽  
Vol 10 (13) ◽  
pp. 2779
Author(s):  
Sang-Hwa Lee ◽  
Yeonkyeong Lee ◽  
Minji Song ◽  
Jae Jun Lee ◽  
Jong-Hee Sohn
Keyword(s):  
Chronic Migraine ◽  
Frontal Lobe ◽  
Iowa Gambling Task ◽  
Medication Overuse Headache ◽  
Wisconsin Card Sorting Test ◽  
Episodic Migraine ◽  
Frontal Lobe Dysfunction ◽  
Card Sorting ◽  
Cross Sectional ◽  
Frontal Lobe Function

Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM − MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM–MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

Neck Pain and Other Location Patterns in Episodic and Chronic Migraine: A Cross-Sectional Study

2020 ◽  
Author(s):  
Marco Antonio Takashi Utiumi ◽  
João Guilherme Bochnia Küster ◽  
Keryn Sporh Godk ◽  
Nikolai José Eustátios Kotsifas ◽  
Pedro André Kowacs ◽  
...  
Keyword(s):  
Neck Pain ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Diagnostic Value ◽  
Multivariate Logistic Regression Model ◽  
Tactile Allodynia ◽  
Cross Sectional ◽  
Pain Location ◽  
Significant Difference ◽  
Location Patterns

Abstract Background: The pain location of migraine has limited diagnostic value and has usually been assessed using non-standard verbal descriptors.Methods: This study uses non-verbal descriptors of pain location in episodic and chronic migraineurs seen at 3 centers of different complexities (tertiary-level hospital and outpatient clinics) and from different sectors (public and private). The explicit pain location was recorded by asking patients to indicate in an electronic form 3 points on the anterolateral side and 3 points on the posterolateral side of the head and neck. A multivariate logistic regression model was fitted to assess the association of different pain location patterns with demographic and clinical variables.Results: Ninety-seven episodic migraine and 113 chronic migraine patients were included, with the most commonly affected sites being the frontal (73% and 65%, respectively), temporal (67% and 73%, respectively) and parietal (27% and 34%, respectively) regions. The posterior cervical site was most often involved in the chronic migraine group (21% vs. 33%, p=0.034). No other locations showed a significant difference. The adjusted model showed that diffuse pain (OR=13.74, CI=4.89-49.85) and the presence of medication overuse associated with tactile allodynia (OR=2.65, CI=1.05-6.87) were associated with increased odds of neck pain. Disease duration was marginally relevant (p=0.078).Conclusions: The migraine attacks most commonly involve the fronto-temporal regions, although neck pain can be more often found in chronic migraine. Some features commonly found in this group such as more diffuse pain, tactile allodynia, and medication overuse are associated with this extratrigeminal site of pain.

HLA class I alleles are associated with clinic-based migraine and increased risks of chronic migraine and medication overuse

Cephalalgia ◽  
2020 ◽  
Vol 40 (5) ◽  
pp. 493-502
Author(s):  
Claire Huang ◽  
Shih-Pin Chen ◽  
Yu-Han Huang ◽  
Hsuan-Yu Chen ◽  
Yen-Feng Wang ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medical Center ◽  
Medication Overuse Headache ◽  
Human Leukocyte ◽  
Population Based ◽  
Class I ◽  
Leukocyte Antigen ◽  
Antigen B

Objective We aimed to evaluate associations of human leukocyte antigen variants with migraine or headache in hospital and population-based settings. Methods The case-control study population, aged 30–70, included 605 clinic-based migraine patients in a medical center and 8449 population-based participants in Taiwan Biobank (TWB). Clinic-based cases were ascertained by neurologists. Participants in Taiwan Biobank were interviewed by a structured questionnaire including headache and migraine history; among them, 2394 had headache or migraine history while 6055 were free of headache and served as controls. All subjects were genotyped by Axiom Genome-Wide Single Nucleotide Polymorphism Arrays and imputed for eight classical human leukocyte antigen genes. Human leukocyte antigen frequencies were compared between clinic-based and self-reported patients and controls. We utilized likelihood ratio tests to examine human leukocyte antigen-disease associations and logistic regressions to estimate the effect of human leukocyte antigen alleles on migraine. Results Human leukocyte antigen -B and C showed significant associations with clinic-based migraine ( q-value < 0.05). Human leukocyte antigen -B*39:01, human leukocyte antigen -B*51:01, human leukocyte antigen -B*58:01 and human leukocyte antigen -C*03:02 were significantly associated with migraine, with age and sex-adjusted odds ratios (95% CIs) of 1.80 (1.28–2.53), 1.50 (1.15–1.97), 1.36 (1.14–1.62) and 1.36 (1.14–1.62), correspondingly. Clinic-based migraineurs carrying human leukocyte antigen -B*58:01 or human leukocyte antigen -C*03:02 had 1.63 (1.11–2.39) -fold likelihood to have chronic migraine with medication-overuse headache compared to episodic migraine. However, no human leukocyte antigen genes were associated with self-reported headache or migraine in the community. Conclusions Human leukocyte antigen class I genetic variants are positively associated with risk of clinic-based migraine but not self-reported migraine or headache and may contribute to migraine chronification and medication overuse.

scholarly journals Increased cerebral responses to salient transitions between alternating stimuli in chronic migraine with medication overuse headache and during migraine attacks

Cephalalgia ◽  
2019 ◽  
Vol 39 (8) ◽  
pp. 988-999 ◽  
Author(s):  
Volodymyr B Bogdanov ◽  
Olena V Bogdanova ◽  
Alessandro Viganò ◽  
Quentin Noirhomme ◽  
Steven Laureys ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Blood Oxygenation Level Dependent ◽  
Pain Modulation ◽  
Blood Oxygenation ◽  
Blood Oxygenation Level ◽  
Oxygenation Level ◽  
Headache Patients

Introduction In a previous study exploring central pain modulation with heterotopic stimuli in healthy volunteers, we found that transitions between sustained noxious and innocuous thermal stimulations on the foot activated the “salience matrix”. Knowing that central sensory processing is abnormal in migraine, we searched in the present study for possible abnormalities of these salient transitional responses in different forms of migraine and at different time points of the migraine cycle. Methods Participants of both sexes, mostly females, took part in a conditioned pain modulation experiment: Migraineurs between (n = 14) and during attacks (n = 5), chronic migraine patients with medication overuse headache (n = 7) and healthy volunteers (n = 24). To evoke the salience response, continuous noxious cold or innocuous warm stimulations were alternatively applied on the right foot. Cerebral blood oxygenation level dependent responses were recorded with fMRI. Results Switching between the two stimulations caused a significant transition response in the “salience matrix” in all subject groups (effect of the condition). Moreover, some group effects appeared on subsequent post-hoc analyses. Augmented transitional blood oxygenation level dependent responses in the motor cortex and superior temporal sulcus were found in two patient groups compared to healthy controls: chronic migraine with medication overuse headache patients and migraineurs recorded during an attack. In chronic migraine with medication overuse headache patients, salience-related responses were moreover greater in the premotor cortex, supplementary motor area, lingual gyrus and dorso-medial prefrontal cortex and other “salience matrix” areas, such as the anterior cingulate and primary somatosensory cortices. Conclusion This study shows salience-related hyperactivation of affective and motor control areas in chronic migraine with medication overuse headache patients and, to a lesser extent, in episodic migraine patients during an attack. The greater extension of exaggerated blood oxygenation level dependent responses to unspecific salient stimuli in chronic migraine with medication overuse headache than during a migraine attack could be relevant for headache chronification.

Low cognitive reserve is associated with chronic migraine with medication overuse and poor quality of life

Cephalalgia ◽  
2014 ◽  
Vol 35 (8) ◽  
pp. 683-691 ◽  
Author(s):  
Marian Gómez-Beldarrain ◽  
Ane Anton-Ladislao ◽  
Urko Aguirre-Larracoechea ◽  
Isabel Oroz ◽  
Juan Carlos García-Moncó
Keyword(s):  
Quality Of Life ◽  
Chronic Migraine ◽  
Cognitive Reserve ◽  
Medication Overuse ◽  
Univariate Analysis ◽  
Poor Quality ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Sf 36

Objective The objective of this article is to test the hypothesis that cognitive reserve (CR) is related to migraine chronification, medication overuse and poor quality of life in migraineurs. Design/methods A cross-sectional study on patients with chronic migraine with medication overuse (CM-MOH), episodic migraine (EM), and controls, matched by sex, age and education, was carried out. CR was assessed by a specific questionnaire, and quality of life was measured by general and specific questionnaires (SF-36 and MSQoL). Migraine Disability Assessment Scale and Beck questionnaires for depression and anxiety were used. Medication dependence was evaluated by the medication-dependence questionnaire in headache (MDQ-H). Results Fifty-five individuals were enrolled: 18 CM-MOH patients (32.73%), 22 EM patients (40%) and 15 controls (27.27%). Fifty (90.91%) of them were females and aged 43.53 (7.54) years. Univariate analysis showed a significant association between the study group and CR, and all items of the SF-36, anxiety and depression questionnaires, MSQoL and MDQ-H. The lower CR and CM-MOH group were related to a worse quality of life, more anxiety and depression and the highest medication dependence scores. Multivariate analysis showed that higher CR scores were related to higher quality of life as measured by the physical and mental composite scores of the SF-36, and to lower anxiety (beta = −1.08, p = 0.001) and depression (beta = −0.56, p = 0.03) levels. Focusing on MSQoL, the increase in CR was predictive of a better quality of life (beta = 1.88, p < 0.0001). By all the models, the explained variance of the sample ranged from 39% (mental composite score) to 58% (MSQoL). Conclusions Low CR appears to be an independent factor associated with the deterioration of quality of life, the presence of anxiety and depression, and drug dependence and medication overuse in CM-MOH.

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