scholarly journals Cognitive impairment in chronic migraine: a cross-sectional study in a clinic-based sample

2020 ◽  
Vol 78 (3) ◽  
pp. 133-138 ◽  
Author(s):  
Nina LATYSHEVA ◽  
Elena FILATOVA ◽  
Diana OSIPOVA ◽  
Alexey B. DANILOV
Keyword(s):  
Cognitive Impairment ◽  
Chronic Migraine ◽  
Verbal Learning ◽  
Depression Scale ◽  
Low Frequency ◽  
Preventive Treatment ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional

Abstract Cognitive impairment has been described in all phases of a migraine attack and interictally. However, the prevalence and phenotype of such impairment in chronic migraine (CM) have not yet been studied. Objectives: The aim of this study was to evaluate both the prevalence of the objective cognitive deficit in patients with CM and the factors underlying its etiology. Methods: 144 patients with CM and 44 age-matched patients with low-frequency episodic migraine (EM) (a maximum of 4 headache days per month) participated in this study. Neuropsychiatric characteristics were measured with the HADS Hospital Anxiety and Depression Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20). Results: Compared to EM, CM subjects demonstrated higher subjective and objective cognitive impairment across all tests. CM patients had 4 times higher odds of achieving a RAVLT score in the lower quartile range compared to EM (Odds Ratio [OR] 3.8; 95% confidence interval [95%CI] 1.5‒9.6; р=0.005). In the MoCA, CM patients demonstrated the most striking impairment in memory/delayed recall (65.3%), attention (46.5%), abstraction (30.6%), and language (27.1%). Chronic headache and level of education, but not gender, depression or anxiety, were independent predictors of cognitive impairment. Conclusions: Cognitive impairment is prevalent in the CM population during their mildest possible pain and may be caused by a central sensitization. Timely preventive treatment of EM is warranted.

scholarly journals Depression is not the only cause of cognitive impairment in chronic migraine

2019 ◽  
Vol 8 (4) ◽  
pp. 35-42 ◽  
Author(s):  
N. V. Latysheva ◽  
E. G. Filatova ◽  
D. V. Osipova
Keyword(s):  
Cognitive Impairment ◽  
Chronic Migraine ◽  
Verbal Learning ◽  
Memory Loss ◽  
Depression Scale ◽  
Low Frequency ◽  
Episodic Migraine ◽  
Memory And Attention ◽  
Symbol Substitution ◽  
Learning Test

Background. Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied.Objective – to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology. Materials and methods. We recruited 62 subjects with chronic migraine and 36 genderand age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18–59. All patients filled in the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20).Results. In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval – 1.59–16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment.Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine.

Association of depressive symptoms with allodynia in patients with migraine: A cross-sectional study

Cephalalgia ◽  
2016 ◽  
Vol 36 (11) ◽  
pp. 1077-1081 ◽  
Author(s):  
Marcelo D Mendonça ◽  
André Caetano ◽  
Miguel Viana-Baptista ◽  
Keyword(s):  
Depressive Symptoms ◽  
Strong Association ◽  
Depression Scale ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Multiple Regression Model ◽  
Sectional Study ◽  
Cross Sectional ◽  
Therapeutic Implications ◽  
Demographic Questionnaire

Aims Migraine and depression have a strong association. We aimed to determine whether this relationship was particularly evident in migraineurs with allodynia. Methods A cross-sectional study was carried out of 98 consecutive patients with episodic migraine presenting for their first evaluation in an outpatient clinic. The participants completed a demographic questionnaire, the Allodynia Symptom Checklist and the Hospital Anxiety and Depression Scale (HADS). Results Among the migraineurs, 75 (77%) reported allodynia. Allodynia was associated with higher median HADS-Anxiety (9 vs. 6, p = 0.038) and HADS-Depression (6 vs. 4, p = 0.014) scores. In a multiple regression model, the HADS-Depression scores were independently associated with allodynia (odds ratio 1.236, 95% confidence interval 1.046–1.461). An increased severity of allodynia correlated with higher depression scores ( r = 0.224; p = 0.027). Conclusion Anxious and depressive symptoms are more common in migraineurs with allodynia than in those without allodynia. Further studies are necessary to clarify the relationship between depressive symptoms and allodynia, as well as its therapeutic implications in migraine.

scholarly journals Real-World Functioning in Patients With Schizophrenia: Beyond Negative and Cognitive Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
María Paz García-Portilla ◽  
Leticia García-Álvarez ◽  
Leticia González-Blanco ◽  
Francesco Dal Santo ◽  
Teresa Bobes-Bascarán ◽  
...  
Keyword(s):  
Real World ◽  
Ad Hoc ◽  
Social Performance ◽  
Pearson Correlation ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Digit Symbol Substitution Test ◽  
Symptom Scale ◽  
Cross Sectional ◽  
Symbol Substitution

Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients.Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18–65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation).Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F(7, 131) = 36.371, p < 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate.Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.

Depression in Elderly Patients Attending the Psychiatric Outpatient Department: A Cross Sectional Study

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Dr. Ravi C Sharma ◽  
Dr. Dinesh Dutt Sharma ◽  
Dr. Kamal Parkash
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Cross Sectional ◽  
Psychiatric Outpatient ◽  
Informed Consent Form ◽  
Gandhi Medical College

Background: Cognitive impairment is a common clinical condition among elderly patients suffering with depression and has a well-known aetiology. The present study planned to determine the prevalence of cognitive impairment and depression in geriatric patients attending Psychiatric outpatient department services. Methods: The study was a prospective cross-sectional one and carried out with a sound methodology on elderly patients attending the Psychiatric OPD of Indira Gandhi Medical College, Shimla-1, Himachal Pradesh. A total of 130 patients were screened, out of which 105 patients have fulfilled the inclusion criteria and enrolled after written informed consent form. The cognitive function and depression were assessed by using standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results: Prevalence of cognitive impairment was found 42.9% (44.2% in women, 35.5% in men), whereas the prevalence of depression was found 48.6% (56.30%women, 41.10% men) which was statistically significant (p<0.05).Conclusions: Cognitive impairment and depression were found to be more prevalent in the females than in the males. So, it is advised that psychiatrist should provide special attention for early detection and treatment of depressive symptoms in elderly patients suffering with cognitive impairment.

scholarly journals A cross sectional study on screening for depression among elderly in rural areas of Puducherry, India

2018 ◽  
Vol 7 (1) ◽  
pp. 46
Author(s):  
Pamagal Kavithai ◽  
Anandaraj R. ◽  
Buvaneswary S. ◽  
Prakash M.
Keyword(s):  
Cognitive Impairment ◽  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Geriatric Depression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Study Setting

Background: Depression among elderly has been a neglected health issue. Various factors hinder its early diagnosis. The objectives of this study are to screen for depression among elderly using geriatric depression scale-15 and to determine its influencing factors.Methods: A community based cross sectional study on geriatric depression was done in villages catered by a primary health centre in Puducherry. Permanent residents of the study setting, aged ≥60 years consenting for the study were included. Line listing of elderly individuals in the study setting was done and subjects were selected by simple random sampling. A pretested structured questionnaire was used to collect socio-demographic and clinic-psychological variables. Hindi mental state examination scale was used to screen for cognitive impairment (score <23). Geriatric Depression Scale (GDS-15) was used to screen for depression (score >5) among geriatric individuals. Appropriate statistical tests of significance were done.Results: Among the 360 elderly individuals screened using GDS-15 tool, 41.4% of them were found to be at a higher risk of developing depression. Significant factors for risk of depression in univariate analysis include being female, illiterate, unemployed, widow/single, having sleep problems, dependency in activities of daily living and cognitive impairment. Predictors for risk of depression evident by multivariate analysis include presence of unemployment, sleep problems and cognitive impairment.Conclusions: A higher proportion of elderly was observed to be at risk of depression.  Primary care physicians may consider screening for depression in elderly with identified risk factors and act accordingly.

scholarly journals Prevalence of Cognitive Impairment and Depression among a Population Aged over 60 Years in the Metropolitan Area of Guadalajara, Mexico

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Genaro G. Ortiz ◽  
Elva D. Arias-Merino ◽  
María E. Flores-Saiffe ◽  
Irma E. Velázquez-Brizuela ◽  
Miguel A. Macías-Islas ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Metropolitan Area ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Issue ◽  
Prevalence Of Depression ◽  
Highly Correlated ◽  
State Examination

Background. Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology because of the variable rate of neurodegenerative changes associated with depression. The aim of the present work was to examine the prevalence of cognitive impairment and depression in a representative sample of adults aged≥60 years.Methods. The presented work was a cross-sectional study on the prevalence of cognitive impairment and depression. Door-to-door interview technique was assigned in condition with multistage probability random sampling to obtain subjects that represent a population of the Guadalajara metropolitan area (GMA), Mexico. Cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively.Results. Prevalence of cognitive impairment was 13.8% (14.5% women, 12.6% men); no significant differences by gender and retired or pensioner were found. Prevalence of depression was 29.1% (33.6% women, 21.1% men); no significant differences by retired or pensioner were found. Cognitive impairment was associated with depression (OR  =  3.26, CI 95%, 2.31–4.60). Prevalence of cognitive impairment and depression is associated with: being woman, only in depression being older than 75 years being married, and a low level of education.Conclusion. Cognitive impairment and depression are highly correlated in adults aged≥60.

Factors associated to chronic migraine with medication overuse: A cross-sectional study

Cephalalgia ◽  
2018 ◽  
Vol 38 (14) ◽  
pp. 2045-2057 ◽  
Author(s):  
Michele Viana ◽  
Sara Bottiroli ◽  
Grazia Sances ◽  
Natascia Ghiotto ◽  
Marta Allena ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Preventive Medication ◽  
History Of

Background and aim Factors implicated in the evolution of episodic migraine into chronic migraine are largely elusive. Medication overuse is considered to be one of the main determinants, but other possible clinical and psychological factors can play a role. The aim of this study is to identify factors that are associated with chronic migraine with medication overuse. Method We enrolled consecutive migraine patients, subdividing them in two groups: Subjects with a long history of episodic migraine and subjects with chronic migraine and medication overuse. We then compared their clinical and psychological variables in a cross-sectional study. Results Three hundred and eighteen patients were enrolled, of which 156 were episodic migraine and 162 were chronic migraine and medication overuse patients. The mean age was 42.1 ± 10.3, 80.8% were female. The duration of migraine was 24.6 years in episodic migraine and 24.0 years in chronic migraine and medication overuse ( p = 0.57). After the multivariate analysis, the factors associated to chronic migraine and medication overuse were: Marital status (married vs. unmarried, OR 3.65, 95% CI 1.63–8.19, p = 0.002; separated/divorced/widowed vs. unmarried, OR 4.19, 95% CI 1.13–15.47, p = 0.031), physical activity (OR 0.42, 95% CI 0.19–0.91, p = 0.029), age at onset of migraine (OR 0.94, 95% CI 0.89–0.98, p = 0.016), use of at least one migraine preventive medication (OR 2.36, 95% CI 1.18–4.71, p = 0.014), history of depression (OR 2.91, 95% CI 1.25–6.73, p = 0.012), insomnia associated with the use of hypnotics (OR 5.59, 95% CI 1.65–18.93, p = 0.006), traumatic head injuries (OR 3.54, 95% CI 1.57–7.99, p = 0.002), snoring (OR 2.24, 95% CI 1.05–4.79, p = 0.036), previous and/or actual use of combined oral contraceptives (OR 3.38, 95% CI 1.10–10.3, p = 0.031) and higher scores in the Childhood Trauma questionnaire (OR 1.48, 95% CI 1.09–2.02, p = 0.012). Conclusion We considered several aspects that may be involved in the development of chronic migraine and medication overuse. A multivariate analysis identified 10 factors belonging to five different areas, to suggest that chronic migraine and medication overuse onset is likely influenced by a complex mixture of factors. This information is useful when planning strategies to prevent and manage chronic migraine and medication overuse.

scholarly journals Patients and general practitioners assessment of the main outcomes employed in the acute and preventive treatment of migraine: a cross sectional study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javier Trigo-López ◽  
Ángel Luis Guerrero-Peral ◽  
Álvaro Sierra ◽  
Enrique Martínez-Pías ◽  
María Gutiérrez-Sánchez ◽  
...  
Keyword(s):  
General Practitioners ◽  
Preventive Treatment ◽  
Symptomatic Treatment ◽  
Episodic Migraine ◽  
Cross Sectional Study ◽  
Important Variable ◽  
Migraine Treatment ◽  
Cross Sectional ◽  
Sustained Effect ◽  
Action Time

Abstract Background We aim to describe and compare patients and general practitioners’ opinions about the different variables related to acute and preventive treatment for migraine. Patients and methods An observational descriptive study was performed. Patients with episodic migraine and general practitioners, from our healthcare area, were invited to answer a survey about the different variables related to migraine treatment. They were asked for their opinions on the different variables, and to consider the desired efficacy in percentage terms and the desired action times of treatment. Results Fifty-five patients and fifty-five general practitioners were selected. Effectiveness was considered the most important variable for symptomatic and preventive treatment. Cost was considered the least important variable. Patients desired percentage of efficacy was 84.0% (±16.7%) for symptomatic treatment and 79.9% (±17.1%) for preventive treatment. General practitioners desired percentage of efficacy was 75.0% (±14.0) for symptomatic treatment and 70.4% (±14.3) for preventive treatment. For symptomatic treatment the desired action time for pain cessation was selected as 27.5 min (±13.8) for patients and 24.0 min (±18.3) for GPs. For preventive treatment the desired action time for effect was 7.1 days (±4.5) for patients and 13.9 days (±8.9) for general practitioners. Conclusion The most important endpoints were, for acute: effectiveness, a short action time and a persistent effect. For prophylactic: effectiveness, sustained effect and tolerability. Both patients and general practitioners agreed on the most and least preferred endpoints. Desired percentage of efficacy was above 75% for both symptomatic and preventive treatment; and the desired action time was below 30 min for acute treatment and 2 weeks for preventive treatment.

The Association between Depressive State and Maternal Cognitive Function in Postpartum Women

2018 ◽  
Vol 36 (03) ◽  
pp. 285-290 ◽  
Author(s):  
Eyal Sheiner ◽  
Tamar Wainstock ◽  
Monic Attias ◽  
Asnat Walfisch ◽  
Elad Mazor
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Postpartum Depression ◽  
Postpartum Period ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Test Results ◽  
Self Assessment ◽  
Variable Model ◽  
Cross Sectional

Objective Maternal amnesia is a transitional cognitive impairment occurring during pregnancy and the postpartum period. We evaluated the prevalence and extent of this suggested cognitive decline and the role of postpartum depression. Study Design A cross-sectional study was performed in women during the immediate postpartum period. Eligible women completed the Edinburgh Postnatal Depression Scale (EPDS). Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test, SDMT90, and SDMT4) and a subjective self-estimation questionnaire (Attention Function Index [AFI]). Results A total of 120 women completed the study questionnaires; 33.3% (40 women) exhibited signs of postpartum depression (EPDS ≥10). The subjective AFI test results correlated with the objective SDMT90 test results (r 2 = 0.2, p = 0.039). Depressed mothers scored significantly lower in the subjective AFI test (67.69 ± 12.01 in the study vs. 79.05 ± 14.3 in the comparison group; p < 0.001) and nearly significantly lower in the objective SDMT test (p = 0.057). In the multi-variable model, maternal depression was independently associated with the subjective AFI score (β  = −13.7; 95% confidence interval [CI]: −19.1 to −8.2, p < 0.001) but not with the objective SDMT score (β = −3.48; 95% CI −8.3 to 1.3, p = 0.15), while controlling for maternal age, gestational age, and ethnicity. Conclusion Postpartum depression is common and appears to predominantly affect maternal self-assessment of cognitive ability, rather than a true cognitive impairment.

scholarly journals Opioids and Migraine: Opioid Awareness and Frequency of Use among Turkish Migraineurs

2019 ◽  
Vol 7 (3) ◽  
pp. 139-145
Author(s):  
D. H. Ertem ◽  
C. I. Basarir ◽  
G. Baran ◽  
N. Gonderten ◽  
F. Ilik
Keyword(s):  
Chronic Migraine ◽  
Episodic Migraine ◽  
Opioid Therapy ◽  
Cross Sectional Study ◽  
Migraine Treatment ◽  
Opioid Use ◽  
Cross Sectional ◽  
Opioid Prescription ◽  
Cardiovascular Comorbidities ◽  
Frequency Of Use

Despite the inadequate evidence of effi cacy and safety of opioid use for the treatment of migraine, it has been reported that patients with moderate to severe migraine headaches are prescribed opioids. Migraineurs may experience serious health impacts from opioids such as headache-related disability, psychiatric and cardiovascular comorbidities. The reduction of the risk of opioid abuse and prevention of an opioid epidemic are important public health challenges. The aim of this study was to assess the awareness of opioid therapy for migraine and the frequency of use among Turkish patients with episodic and chronic migraine. Materials and methods: consecutive migraine patients were enrolled in this cross-sectional study. A semi-structured questionnaire was developed and used by the researchers to assess the patients’ awareness of an opiod treatment option and the frequency of use of opioids for migraine treatment. Results. One hundred two patients were enrolled, of which 72 had episodic migraine and 30 had chronic migraine. All subjects reported that they had not been offered or prescribed any kind of opioids by general practitioners and neurologists for their headache. Besides, only 7 % of patients declared that they had heard of opioid treatment for migraine but they had never consulted their doctors about its effects. Conclusions. Our fi ndings demonstrated that opioids were not preferred as an option for acute or preventive migraine treatment by Turkish migraineurs and their physicians. The reduction of opioid prescription will help to prevent the development of medication overuse and opiate-induced headaches and drug addiction.

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