Disability, burden, and symptoms related to sensitization in migraine patients associate with headache frequency

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Stefano Di Antonio ◽  
Matteo Castaldo ◽  
Marta Ponzano ◽  
Francesca Bovis ◽  
Paola Torelli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Migraine ◽  
High Frequency ◽  
Low Frequency ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Headache Attack ◽  
Burden Of Headache ◽  
The Difference

Abstract Objectives This observational study aimed to assess the difference in disability, burden, and sensitization between migraine patients with low-frequency headache attack (1–8 headache days/month), high-frequency headache attack (9–14 headache days/months), and patients with chronic migraine (>14 headache days/months). Methods Migraine patients with or without aura were divided into three groups according to headache frequency (low-frequency episodic migraine; high-frequency episodic migraine; chronic migraine). Questionnaires were used to assess the burden of headache, quality of life, phycological burden, and symptoms related to sensitization (estimated by the Central Sensitization Inventory). Differences among migraine groups were assessed using Chi-Quadro test, ANOVA, or Kruskal–Wallis as appropriate. Results 136 patients were included (68 low-frequency episodic migraine, 45 high-frequency episodic migraine, 23 chronic migraine). Patients with high frequency episodic migraine and chronic migraine differed from patients with low frequency episodic migraine showing a worse burden of headache (p=0.002; p=0.002), worse level of physical (p=0.001; p<0.001) and mental (p=0.002; p=0.001) quality of life, worse level of depression (p=0.008; p=0.003), and increase presence of symptoms related to sensitization (p<0.001; p=0.003). No differences were found in any variables between patients with high-frequency episodic migraine and patients with chronic migraine (p>0.05). Conclusions Patients with high-frequency episodic migraine and chronic migraine could be considered in the same segment of the migraine population, with similar degrees of disability and sensitization related symptoms.

The clinical and public health implications and risks of widening the definition of chronic migraine

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Martina Guglielmetti ◽  
Alberto Raggi ◽  
Raffaele Ornello ◽  
Simona Sacco ◽  
Domenico D’Amico ◽  
...  
Keyword(s):  
Public Health ◽  
Chronic Migraine ◽  
High Frequency ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Allocation Of Resources ◽  
Independent Entity ◽  
Definition Of ◽  
The Impact

Background The definition of chronic migraine has long been debated. Recently, it was suggested to define subjects with at least 8/migraine days as chronic migraine; that is, incorporating so-called high frequency episodic migraine (eight or more migraine days but less than 15 headache days per month). Methods We addressed the possible problems that might arise based on this proposal accounting for clinical, pathophysiological, impact and public health aspects. Results and conclusions Defining chronic migraine on the basis of headache frequency alone does not account for clinical and pathophysiological aspects, as well as for the impact of chronic migraine in terms of disability and quality of life. Moreover, it is potentially harmful for patients in terms of allocation of resources. These issues are discussed in the present manuscript, and we support the idea of defining high frequency episodic migraine as an independent entity as a viable path to follow.

Mind–body interactive qigong improves physical and mental aspects of quality of life in inpatients with stroke: A randomized control study

2019 ◽  
Vol 18 (8) ◽  
pp. 658-666 ◽  
Author(s):  
Ching-Hsiang Chen ◽  
Kuo-Sheng Hung ◽  
Yu-Chu Chung ◽  
Mei-Ling Yeh
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
High Frequency ◽  
Standard Care ◽  
Low Frequency ◽  
Control Group ◽  
Subacute Stroke ◽  
Interactive Exercise

Background: Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. Objectives: This study was designed to evaluate the effect of a mind–body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. Methods: A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind–body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). Results: The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 ( p<0.05) than the control group. Among the covariates, neurologic deficit ( p=0.04), muscle strength ( p=0.04), low frequency to high frequency ratio ( p=0.02) and anxiety ( p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life ( p >0.05). Conclusions: This study supports the potential benefits of a 10-day mind–body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.

scholarly journals Severity of depressive symptoms as predictor of impairment of quality of life in chronic migraine: Comparison with episodic migraine

2008 ◽  
Vol 62 (6) ◽  
pp. 738-740 ◽  
Author(s):  
Leonides Canuet ◽  
Ryouhei Ishii ◽  
Otman Fernandez-Concepcion ◽  
Masao Iwase ◽  
Masatoshi Takeda
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Chronic Migraine ◽  
Episodic Migraine

When does chronic migraine strike? A clinical comparison of migraine according to the headache days suffered per month

Cephalalgia ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 104-113 ◽  
Author(s):  
M Torres-Ferrús ◽  
M Quintana ◽  
J Fernandez-Morales ◽  
J Alvarez-Sabin ◽  
P Pozo-Rosich
Keyword(s):  
Chronic Migraine ◽  
High Frequency ◽  
Daily Life ◽  
Low Frequency ◽  
Episodic Migraine ◽  
Predictive Capacity ◽  
The Poor ◽  
Clinical Comparison ◽  
Current Classification ◽  
Poor Outcomes

Introduction According to the IHCD-3β classification, chronic migraine (CM) is headache occurring on 15 or more days/month. Episodic migraine (EM) can be divided into low frequency (LFEM) and high frequency (HFEM) depending on the headache days suffered per month. Methods We performed a clinical comparison of migraine characteristics according to monthly headache days suffered. Patients were divided into three groups: LFEM (1–9 headache days/month), HFEM (10–14 headache days/month) and CM (≥15 headache days/month). Results The analysis included 1109 patients. Previously reported differences between EM and CM were replicated. However, there were three times more clinical differences between LFEM and HFEM than between HFEM and CM (15 vs. 6). A new model that takes 10 headache days as a cut-off value for CM would have a minimally higher predictive capacity (72.8%) and no statistical differences (71.8%) when comparing it to the current classification. Conclusions HFEM patients have few clinical differences compared with CM patients. This includes the poor outcomes regarding headache-related disability and impact on daily life. According to these findings, neurologists and headache specialists should consider that the emotional and functional impact in HFEM patients could be as disabling as in those with CM.

scholarly journals Profiling the Extent and Location of Pain in Migraine and Cervicogenic Headache: A Cross-sectional Single-Site Observational Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3512-3521
Author(s):  
Sureeporn Uthaikhup ◽  
Marco Barbero ◽  
Deborah Falla ◽  
Munlika Sremakaew ◽  
Surat Tanrprawate ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Chronic Migraine ◽  
Episodic Migraine ◽  
Cervicogenic Headache ◽  
Cross Sectional ◽  
Pain Location ◽  
Headache Type ◽  
Pain Extent

Abstract Objectives The primary aim was to quantify and compare the location and extent of pain in people with either episodic migraine, chronic migraine, or cervicogenic headache. A secondary aim was to examine the associations between pain extent and headache features, quality of life, and psychological distress for each headache type. Design A cross-sectional, single-site, observational study. Setting Headache outpatient clinic. Subjects From a sample of 390 patients, 114 patients with migraine or cervicogenic headache (48 episodic migraine, 30 chronic migraine, 36 cervicogenic headache) were eligible for the study. Methods Pain location and extent were determined using a novel approach for digital pain drawing acquisition and analysis. Headache features included intensity and history duration. Quality of life was measured using the SF-36 and psychological distress using the Hospital Anxiety and Depression Scale. Results Overall, pain was most frequently reported in the frontal and temporal regions in patients with either episodic or chronic migraine, whereas pain was most frequent in the suboccipital region in patients with cervicogenic headache. A larger pain extent was moderately correlated with higher headache intensity (rs = 0.53, P = 0.003) and poorer quality of life (rs ranged from –0.36 to –0.40, P &lt; 0.05) in patients with chronic migraine, whereas pain extent was associated with longer headache duration in those with cervicogenic headache (rs = 0.35, P = 0.04). No correlation was found between pain extent and psychological features for any headache type (P &gt; 0.05). Conclusions Despite some differences, there was a large symptomatic overlap between headache types, highlighting the limitations of using pain location in the differential diagnosis of headache.

scholarly journals Shift from high-frequency to low-frequency episodic migraine in patients treated with Galcanezumab: results from two global randomized clinical trials

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jakub Jedynak ◽  
Eric Eross ◽  
Astrid Gendolla ◽  
Mallikarjuna Rettiganti ◽  
Virginia L. Stauffer
Keyword(s):  
Quality Of Life ◽  
Migraine Headache ◽  
Disease Burden ◽  
Randomized Clinical Trials ◽  
Low Frequency ◽  
Episodic Migraine ◽  
Double Blind ◽  
Link Type ◽  
Post Hoc

Abstract Background Patients with episodic migraine (EM) with a higher-frequency of migraine headache days (HFEM: 8–14 migraine headache days/month) have a greater disease burden and a higher risk of progressing to chronic migraine (CM) with associated acute treatment overuse versus those with low-frequency EM (LFEM: 4–7 migraine headache days/month). In this post hoc analysis, we assessed the proportions of patients who shifted from HFEM to LFEM and to very low-frequency EM (VLFEM: 0–3 migraine headache days/month) status following treatment with galcanezumab versus placebo. Methods EVOLVE-1 and EVOLVE-2 were double-blind, Phase 3 studies in patients with EM. Patients (18–65 years) were randomized (2:1:1) to subcutaneous monthly injections of placebo, galcanezumab 120 mg (240 mg loading dose) or 240 mg, for up to 6 months. Data were pooled and endpoints were change from baseline in number of migraine headache days/month and patients who shifted from HFEM to LFEM or VLFEM status. Impact of change in HFEM status on migraine headache days/month, quality of life and disability was also assessed. Results A total of 66% (1176/1773) patients from EVOLVE studies had HFEM status at baseline and were included in this analysis; placebo: 592, galcanezumab 120 mg: 294 and galcanezumab 240 mg: 290. At each month, both doses of galcanezumab resulted in a higher proportion of patients who shifted to 0–7 monthly headache days/month (VLFEM or LFEM status). Patients who shifted from HFEM at baseline to VLFEM status at Month 3, a relatively larger proportion of patients on galcanezumab 120 mg versus placebo remained at VLFEM status at Months 4–6; Months 4–5 for galcanezumab 240 mg versus placebo. Among the galcanezumab-treated patients who did-not-shift or shifted to LFEM or VLFEM status for ≥3 consecutive months until the end of the study, patients who shifted from HFEM to VLFEM status experienced the largest reduction in migraine headache days/month and the largest clinically meaningful improvements in daily functioning (MSQ-RFR) and disability (MIDAS). Conclusions In patients with HFEM, treatment with galcanezumab (120 mg and 240 mg) significantly reduced migraine headache days/month, maintained remission status at subsequent months until the end of the study, and improved patients’ quality of life versus placebo. Trial registration ClinicalTrials.gov Identifier: EVOLVE-1, NCT02614183; EVOLVE-2, NCT02614196.

Chronic migraine: Classification and comparisons

Cephalalgia ◽  
2011 ◽  
Vol 31 (5) ◽  
pp. 520-529 ◽  
Author(s):  
Z Katsarava ◽  
A Manack ◽  
M-S Yoon ◽  
M Obermann ◽  
H Becker ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Chronic Migraine ◽  
High Frequency ◽  
Low Frequency ◽  
Epidemiological Data ◽  
Field Testing ◽  
Episodic Migraine ◽  
Case Definition ◽  
Descriptive Statistics ◽  
Chi Square

Objective: The objective of our study was to field test different chronic migraine (CM) criteria and compare CM epidemiological profiles, which include demographic, personal, and lifestyle characteristics, with high-frequency episodic migraine (HFEM) and low-frequency episodic migraine (LFEM). Methods: Questionnaires were mailed to a random sample of 18,000 18–65-year-olds in demographically diverse regions of Germany. The epidemiological data for the three classifications of CM, LFEM and HFEM were assessed using descriptive statistics, Pearson Chi-square, and analysis of variance tests. Results: Among 9350 respondents, CM_I was the most restrictive ( N = 37, 0.4%), followed by CM_II ( N = 45, 0.5%) and CM_III ( N = 185, 2.0%). CM groups did not differ in distribution by age, gender, body mass index, education or smoking and alcohol consumption. Compared to those with LFEM and HFEM, those with CM (CM_III) had significantly different epidemiological profiles. Conclusions: CM prevalence varies by case definition. The epidemiological profiles of the three CM groups are similar but differ significantly from those of HFEM and LFEM. Optimal definitions for clinical practice and epidemiological research require additional field testing.

Relationship between Malocclusion and Heart Rate Variability Indices in Young Adults

2011 ◽  
Vol 50 (04) ◽  
pp. 358-363 ◽  
Author(s):  
N. Takeuchi ◽  
M. Furuta ◽  
T. Tomofuji ◽  
M. Morita ◽  
D. Ekuni
Keyword(s):  
Quality Of Life ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Young Adults ◽  
Chronic Stress ◽  
High Frequency ◽  
Low Frequency ◽  
The Relationship ◽  
Oral Impacts

Summary Objectives: Heart rate variability (HRV) has been used to assess sympathetic and parasympathetic modulation of heart rate. Chronic stress relates to reduced HRV. Malocclusion has effects on quality of life, which can lead to chronic stress. Therefore, we hypothesized that malocclusion, as chronic stress, may contribute to reduced HRV. The aim of this study was to investigate the relationship between malocclusion and HRV indices in healthy young adults. Methods: Thirty-seven non-smoking healthy subjects, aged 22 to 25 years, were examined. Malocclusion was defined by Angle classification. HRV indices included root mean square of successive differences, low frequency (LF), high frequency (HF) and ratio of LF to HF. The effects of malocclusion on quality of life and mental health were assessed using self-reported questionnaires, the condition-specific Oral Impacts on Daily Performances index (CS-OIDP) and the Hopkins Symptoms Checklist (HSCL), respectively. Results: Significantly lower score of HF and higher heart rate (HR) level and CS-OIDP score were observed in subjects with malocclusion (n = 17) compared to those in the control subjects (n = 20) (P < 0.05). There was a positive correlation between HR and score of “anxiety” in HSCL (P < 0.05). Conclusions: The data showed an association between malocclusion and lower HRV. Based on our results, orthodontic treatment might contribute not only to improvement of oral esthetic and functional problems but also to improvement of stress and HRV indices.

Increased prevalence of small airways dysfunction in patients with systemic sclerosis as determined by impulse oscillometry

Rheumatology ◽  
2019 ◽  
Author(s):  
Martina Bonifazi ◽  
Nicola Sverzellati ◽  
Eva Negri ◽  
Giovanni Pomponio ◽  
Valeria Seletti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Frequency ◽  
Small Airways ◽  
Impulse Oscillometry ◽  
Therapeutic Implications ◽  
Radiological Features ◽  
Related Quality ◽  
St George's Respiratory Questionnaire ◽  
The Difference

Abstract Objectives The prevalence and clinical implications of small airways involvement in SSc are still to be fully elucidated. The goal of the present work is to assess the prevalence of small airways dysfunction by impulse oscillometry and to determine whether it correlates with selected disease-related features and respiratory-related quality of life. Methods Ninety-four SSc patients and 93 healthy controls were studied by impulse oscillometry measurements. Small airways dysfunction was defined as the difference between resistance at low frequency, i.e. 5 Hz, and resistance at high frequency, i.e. 20 Hz, termed ‘R5-R20’, ⩾0.07 kPa/l/s. The St George’s Respiratory Questionnaire was used to measure health impairment in SSc patients. Radiological features of small airways disease and parenchymal abnormalities on high resolution CT chest scans were jointly assessed by two thoracic radiologists. Results Small airways dysfunction was present in 21.5% of the SSc patient cohort, with a prevalence almost 5-fold higher compared with controls, and it was significantly associated with worse respiratory-related quality of life. Radiological features consistent with small airways abnormalities were detected in 25% of SSc patients, mostly in the absence of interstitial lung changes. Combining functional and radiological evaluations, one-third of the SSc cohort showed at least one feature of small airways involvement, which was associated with the lcSSc phenotype and with longer disease duration. Conclusion The current study strengthens the hypothesis that small airway dysfunction might be a feature of SSc-related lung involvement, providing the first data on its significant impact on respiratory-related quality of life. A full assessment of lung function in SSc patients should include impulse oscillometry as a complementary technique, due to potential clinical and therapeutic implications.

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