scholarly journals Determining the Evolution of Headache Among Regular Users of a Daily Electronic Diary via a Smartphone App: Observational Study

10.2196/26401 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e26401
Author(s):  
Bianca Raffaelli ◽  
Jasper Mecklenburg ◽  
Lucas Hendrik Overeem ◽  
Simon Scholler ◽  
Markus A Dahlem ◽  
...  
Keyword(s):  
Care Management ◽  
Daily Basis ◽  
Episodic Migraine ◽  
Electronic Diary ◽  
Migraine Frequency ◽  
Major Development ◽  
Acute Medication ◽  
Headache Diary ◽  
Basic Version ◽  
Headache Care

Background Smartphone-based apps represent a major development in health care management. Specifically in headache care, the use of electronic headache diaries via apps has become increasingly popular. In contrast to the soaring volume of available data, scientific use of these data resources is sparse. Objective In this analysis, we aimed to assess changes in headache and migraine frequency, headache and migraine intensity, and use of acute medication among people who showed daily use of the headache diary as implemented in the freely available basic version of the German commercial app, M-sense. Methods The basic version of M-sense comprises an electronic headache diary, documentation of lifestyle factors with a possible impact on headaches, and evaluation of headache patterns. This analysis included all M-sense users who had entered data into the app on a daily basis for at least 7 months. Results We analyzed data from 1545 users. Mean MHD decreased from 9.42 (SD 5.81) at baseline to 6.39 (SD 5.09) after 6 months (P<.001; 95% CI 2.80-3.25). MMD, AMD, and migraine intensity were also significantly reduced. Similar results were found in 985 users with episodic migraine and in 126 users with chronic migraine. Conclusions Among regular users of an electronic headache diary, headache and migraine frequency, in addition to other headache characteristics, improved over time. The use of an electronic headache diary may support standard headache care.

scholarly journals Determining the Evolution of Headache Among Regular Users of a Daily Electronic Diary via a Smartphone App: Observational Study (Preprint)

2020 ◽  
Author(s):  
Bianca Raffaelli ◽  
Jasper Mecklenburg ◽  
Lucas Hendrik Overeem ◽  
Simon Scholler ◽  
Markus A Dahlem ◽  
...  
Keyword(s):  
Care Management ◽  
Daily Basis ◽  
Episodic Migraine ◽  
Electronic Diary ◽  
Migraine Frequency ◽  
Major Development ◽  
Acute Medication ◽  
Headache Diary ◽  
Basic Version ◽  
Headache Care

BACKGROUND Smartphone-based apps represent a major development in health care management. Specifically in headache care, the use of electronic headache diaries via apps has become increasingly popular. In contrast to the soaring volume of available data, scientific use of these data resources is sparse. OBJECTIVE In this analysis, we aimed to assess changes in headache and migraine frequency, headache and migraine intensity, and use of acute medication among people who showed daily use of the headache diary as implemented in the freely available basic version of the German commercial app, M-sense. METHODS The basic version of M-sense comprises an electronic headache diary, documentation of lifestyle factors with a possible impact on headaches, and evaluation of headache patterns. This analysis included all M-sense users who had entered data into the app on a daily basis for at least 7 months. RESULTS We analyzed data from 1545 users. Mean MHD decreased from 9.42 (SD 5.81) at baseline to 6.39 (SD 5.09) after 6 months (<i>P</i>&lt;.001; 95% CI 2.80-3.25). MMD, AMD, and migraine intensity were also significantly reduced. Similar results were found in 985 users with episodic migraine and in 126 users with chronic migraine. CONCLUSIONS Among regular users of an electronic headache diary, headache and migraine frequency, in addition to other headache characteristics, improved over time. The use of an electronic headache diary may support standard headache care.

Comparing prospective headache diary and retrospective four-week headache questionnaire over 20 weeks: Secondary data analysis from a randomized controlled trial

Cephalalgia ◽  
2020 ◽  
Vol 40 (13) ◽  
pp. 1523-1531
Author(s):  
Vanessa E Miller ◽  
Keturah R Faurot ◽  
Olafur S Palssson ◽  
Beth A MacIntosh ◽  
Chirayath Suchindran ◽  
...  
Keyword(s):  
Dietary Intervention ◽  
Controlled Trial ◽  
Secondary Data ◽  
Daily Basis ◽  
Headache Frequency ◽  
Electronic Diary ◽  
Monthly Basis ◽  
Headache Diary ◽  
Two Measures ◽  
Hourly Basis

Background Headache diaries and recall questionnaires are frequently used to assess headache frequency and severity in clinical and research settings. Methods Using 20 weeks of data from an intervention trial with 182 participants, we evaluated concordance between an electronic headache diary administered on a daily basis and designed to capture the presence and severity of headaches on an hourly basis (the headache diary) and a recall questionnaire, with retrospective estimation of the number of headache days assessed on a monthly basis. We further examined whether the duration or severity of headaches assessed by the electronic diary impacted concordance between these two measures. Results Over the course of four 28-day periods, people with migraine participating in a dietary intervention reported an average of 13.7 and 11.1 headache days in the headache diary and recall questionnaire, respectively. Conclusion Over time, the concordance between headache days reported in these two measures tended to increase; however, the recall questionnaire headache estimates were lower than the diary measures in all four periods. When analysis was restricted to headaches lasting 8 hours or more, the number of headache days was more closely aligned with days reported in the recall questionnaire, indicating that the accuracy of recall estimates is likely to be influenced by headache duration. Restriction of analyses to moderate-to-severe headaches did not change results as much as headache duration. The findings indicate that recall questionnaires administered on a monthly basis may underestimate headache frequency and therefore should not be used interchangeably with headache diaries. Clinical Trials.gov Identifier: NCT02012790

scholarly journals Sustained reductions in migraine days, moderate-to-severe headache days and days with acute medication use for HFEM and CM patients taking fremanezumab: Post-hoc analyses from phase 2 trials

Cephalalgia ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Rashmi B Halker Singh ◽  
Ernesto Aycardi ◽  
Marcelo E Bigal ◽  
Pippa S Loupe ◽  
Mirna McDonald ◽  
...  
Keyword(s):  
Medication Use ◽  
Preventive Treatment ◽  
Episodic Migraine ◽  
Phase 2 ◽  
Electronic Diary ◽  
Related Data ◽  
Sustained Reduction ◽  
Acute Medication ◽  
Post Hoc ◽  
Cgrp Antibody

Background In phase 2 and 3 studies, fremanezumab, a monoclonal CGRP antibody, was an effective preventive treatment for high-frequency episodic migraine (HFEM) and chronic migraine (CM). Objective Post-hoc analyses evaluated population-wise 50%, 75% and 100% responder rates, and the extent to which individual responders sustained a 50%, 75% and 100% reduction in migraine days, moderate-to-severe (M/S) headache days and days of acute medication use during all three treatment months of the fremanezumab phase 2 studies. Design/methods HFEM patients received either placebo or three once-monthly injections of 225 mg or 675 mg. CM patients received either placebo or three once-monthly injections of 900 mg, or an initial loading dose of 675 mg and subsequent injections of 225 mg. Patients reported headache-related data daily using an electronic diary. Results In the HFEM study, the percent of patients on fremanezumab doses 225 mg and 675 mg were greater compared to the percent of placebo patients with sustained 50% reduction in migraine days (39% and 35% vs. 10% for placebo, both p < 0.0001), M/S headache days (36% and 38% vs. 16% placebo, p = 0.0017 and p = 0.0007 respectively), and acute medication use days (36% and 27% vs. 8% placebo, p < 0.0001 and p = 0.0003). Likewise, although there were fewer patients with sustained 75% reduction, there were increases in the percent of patients on fremanezumab 225 mg and 675 mg in the HFEM study relative to placebo patients in migraine days (19% and 11% vs. 3% placebo, p = 0.0002 and p = 0.0176), M/S headache days (19% and 15% vs. 2% placebo, p = 0.0001 and p = 0.0011) and days of acute medication use (16% and 8% vs. 2% placebo, p = 0.0005 and p = 0.0377). In the CM study, there were increases in the percent of patients on fremanezumab 675/225 mg and 900 mg with 50% sustained reduction in M/S headache days (32% and 40% vs. 15% placebo, p = 0.0058 and p = 0.0002) and days of acute medication use (26% and 22% vs. 11% placebo, p = 0.0098 and p = 0.0492). There were also increases in the percent of patients on fremanezumab 675/225 mg and 900 mg compared to patients on placebo with 75% sustained reduction in M/S headache days (10% and 13% vs. 3%, p = 0.0665 and p = 0.0203). Few patients had 100% sustained reductions in these parameters in either study. Conclusions Post-hoc results must be interpreted with caution; nonetheless, a statistically significant percentage of patients who initially responded to fremanezumab within 1 month sustained this response over the subsequent 2 months. Sustained reduction in individual patients may provide a novel patient-centric, clinically meaningful endpoint for future trials assessing the effectiveness of preventive migraine treatments. Trials are registered as http://clinical trials.gov as NCT02025556 and NCT02021773.

Comparing patient and parent recall of 90-day and 30-day migraine disability using elements of the PedMIDAS and an Internet headache diary

Cephalalgia ◽  
2013 ◽  
Vol 34 (4) ◽  
pp. 298-306 ◽  
Author(s):  
Geoffrey L Heyer ◽  
Sara Q Perkins ◽  
Sean C Rose ◽  
Shawn C Aylward ◽  
JoEllen M Lee
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Parent Report ◽  
Episodic Migraine ◽  
Headache Frequency ◽  
Patient Age ◽  
Recall Accuracy ◽  
Pediatric Migraine ◽  
Patient Âgé ◽  
Headache Diary

Aim The aim of this article is to compare 90-day and 30-day recall of Pediatric Migraine Disability Assessment (PedMIDAS) elements and headache frequency against daily entries from an Internet headache diary among pediatric patients and their parents. Methods In a prospective cohort study, patients aged 10–18 years with episodic migraine or probable migraine completed a 90-day Internet-based headache diary that incorporated PedMIDAS questions. Following the 90-day diary period, patients and parents completed modified PedMIDAS instruments to assess 90-day and 30-day recall. Intraclass correlation coefficients (ICC) were calculated to measure recall reliability. The Kruskal-Wallis and Jonckheere-Terpstra tests were used to explore recall accuracy as it relates to each participant’s self-reported confidence in recall and to patient age. Results Fifty-two subjects completed 90 consecutive diary entries. Comparing 30-day to 90-day recall of PedMIDAS elements, ICC scores improved by 26.2% (patients) and 17.5% (parents). Patients had better recall than their parents for all study measures. Self-reported confidence in recall and patient age had limited and inconsistent effects on recall accuracy. Conclusion The optimal recall interval to assess migraine disability must balance recall accuracy with generalizability across a range of headache frequencies. When compared to daily diary entries, recall accuracy of PedMIDAS elements and headache frequency improves at 30 days compared to 90 days. Parent report of migraine disability should not be used as a replacement for patient report.

scholarly journals Effects of Botulinum Toxin on Migraine Attack Features in Chronic Migraine: A Six-Month Open-Label Observation Study through Electronic Diary Smartphone Application

Toxins ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 668 ◽  
Author(s):  
Antonio Santoro ◽  
Marianna Delussi ◽  
Maurizio Leone ◽  
Anna Maria Miscio ◽  
Laura De Rocco ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Central Sensitization ◽  
Smartphone Application ◽  
Electronic Diary ◽  
Open Label ◽  
Observation Study ◽  
Nociceptive Transmission ◽  
Headache Diary ◽  
Application Data

OnobotulintoxinA (OBT-A) is a treatment option for Chronic Migraine (CM). It works on central sensitization and pain but its mode of action is still unknown. To observe how OBT-A treatment works on single migraine attacks, this paper covers an over-6-month observation period through self-reported smartphone application data. This was an observational, open-label cohort study conducted on 34 CM patients under OBT-A treatment, selected between December 2016 and December 2017, who agreed to download a smartphone headache diary application (Aid Diary) according to the study instructions. The analysis was conducted using the smartphone application data reports on allodynia, intensity and extension of pain, and vegetative symptoms. We analysed a total of 707 records of single migraine attacks reported by compliant users (n = 34) in real-time. OBT-A significantly reduced allodynia, the number of vegetative symptoms, pain extension and intensity in single migraine attacks. Pain intensity was correlated with pain extension. In single migraine attacks, OBT-A improved symptoms of central sensitization. This action could be exerted by modulating nociceptive transmission and reducing the burden of single migraine episodes and improving the overall quality of life.

Follow-up over 20 months confirms gains of online behavioural training in frequent episodic migraine

Cephalalgia ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 236-250 ◽  
Author(s):  
Marjolijn J Sorbi ◽  
Yannick Balk ◽  
Annet M Kleiboer ◽  
Emile GM Couturier
Keyword(s):  
Training Group ◽  
Episodic Migraine ◽  
Self Management ◽  
Treatment As Usual ◽  
Adequate Treatment ◽  
Headache Diary ◽  
Group 2 ◽  
Group 1

Aim This study examined the change over 20 months in 178 participants with frequent episodic migraine under adequate treatment as usual, who had completed online behavioural training (oBT) in migraine self-management either directly (group 1, n = 120) or after 10 months of watchful waiting (group 2, n = 58). Methods Participants completed questionnaires and an online headache diary and migraine monitor following the International Classification of Headache Disorders at T0 (baseline), T1 (post-training), T2 (6-month follow-up; extended baseline in group 2), T3 (post-training, group 2 only) and T4 (group 1: 16-month follow-up; group 2: 6-month follow-up). Statistical analyses were conducted on the observed data without imputation of missing observations. Results Both groups were highly comparable. The data over time revealed benefits in response to oBT, with significant between-group differences in the change achieved in the training episodes T2–T0 (group 1) and T4–T2 (group 2). Improved attack frequency ( M = –23%) was higher in participants with more (i.e. 4–6) attacks per month at baseline, and the effects of oBT were durable over 16 months of follow-up. Conclusions oBT is beneficial in frequent episodic migraine, which deserves special efforts in care. Self-management variants such as oBT reach patients easily and supplement these efforts with durable results.

scholarly journals Trigger factors mainly from the environmental type are reported by adolescents with migraine

2013 ◽  
Vol 71 (5) ◽  
pp. 290-293 ◽  
Author(s):  
Marcela Dalla Bernardina Fraga ◽  
Ricardo Silva Pinho ◽  
Solange Andreoni ◽  
Maria Sylvia de Souza Vitalle ◽  
Mauro Fisberg ◽  
...  
Keyword(s):  
Migraine Attack ◽  
Episodic Migraine ◽  
The Other ◽  
Trigger Factor ◽  
Trigger Factors ◽  
Headache Diary ◽  
Common Group ◽  
Environmental Causes ◽  
Hot Weather ◽  
As Stress

Migraine can be triggered by many factors such as stress, sleep, fasting and environmental causes. There are few studies that evaluated migraine trigger factors in the adolescent population.Methods:A total of 100 participants from 10 to 19 years were subjected to a detailed headache questionnaire, with demographic and clinical data, and a headache diary including trigger factors during a two-month period was asked.Results:Fifty of the participants exhibited chronic migraine and the other 50 participants demonstrated episodic migraine. The most common group of trigger factors reported was the environmental one, mainly sun/clarity, followed by hot weather and the smell of perfume.Conclusions:Ninety-one percent of children and adolescents with migraine reported a trigger factor precipitating the migraine attack.

scholarly journals Anti-CGRP monoclonal antibodies in chronic migraine with medication overuse: real-life effectiveness and predictors of response at 6 months

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Edoardo Caronna ◽  
Victor José Gallardo ◽  
Alicia Alpuente ◽  
Marta Torres-Ferrus ◽  
Patricia Pozo-Rosich
Keyword(s):  
Monoclonal Antibodies ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Real Life ◽  
Daily Practice ◽  
Headache Frequency ◽  
Electronic Diary ◽  
Life Effectiveness ◽  
Medication Intake ◽  
Acute Medication

Abstract Background In daily practice, anti-CGRP monoclonal antibodies (MAbs) may be useful in chronic migraine (CM) with medication overuse (MO), but data is limited. We evaluated their effectiveness in a real-life clinical cohort. Methods This is a prospective study conducted in CM patients with and without medication overuse treated with monthly MAbs during 6 months (erenumab/galcanezumab). We collected headache characteristics, including acute medication intake, through an electronic diary. We compared patients (1) with and without MO at baseline, (2) with and without ongoing MO after treatment, defining MO resolution as < 10 or 15 days/month of acute medication intake, according to analgesic type, during the 6-month treatment. Results Of 139 CM patients completing 6-month treatment with anti-CGRP MAbs, 71.2% (99/139) had MO at baseline. After 6 months, patients with and without MO at baseline had significant and similar proportions of ≥50% reduction in migraine days/month (MO: 63.6% vs. non-MO: 57.5%, p = 0.500). 60.6% (60/99) no longer satisfied MO definition. Reduction in headache frequency compared to baseline occurred in both MO-ongoing and MO-resolution group, although those who stopped overusing had a greater improvement (headache days/month: − 13.4 ± 7.6 vs. -7.8 ± 7.2, p < 0.0001). No differences in MO resolution were observed according to the MAbs used. Baseline lower pain severity was associated with MO resolution (OR [95%]:0.236[0.054–0.975]; p = 0.049). Conclusions In real-life anti-CGRP MAbs are as effective in CM patients with MO as in patients without it and facilitate MO cessation. Reduction in headache frequency and acute medication days/month occurs regardless of whether patients stop overusing or not.

scholarly journals Inter-individual differences in pain anticipation and pain perception in migraine: Neural correlates of migraine frequency and cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261570
Author(s):  
Gyöngyi Kökönyei ◽  
Attila Galambos ◽  
Natália Kocsel ◽  
Edina Szabó ◽  
Andrea Edit Édes ◽  
...  
Keyword(s):  
Individual Differences ◽  
Allostatic Load ◽  
Pain Perception ◽  
Dehydroepiandrosterone Sulfate ◽  
Brain Regions ◽  
Episodic Migraine ◽  
Neural Activation ◽  
Migraine Frequency ◽  
Two Phases ◽  
The Brain

Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain.

scholarly journals Beneficial Effects of Kiatsu™ with Ki Training on Episodic Migraine: A Single Arm, Pilot, Exploratory Study

2021 ◽  
Author(s):  
Calvin Y Tabata ◽  
Philip Coppenhaver ◽  
Shirley McCartney ◽  
Saman Vazinkhoo ◽  
Terry Copperman
Keyword(s):  
Quality Of Life ◽  
Exploratory Study ◽  
Treatment Options ◽  
Episodic Migraine ◽  
Effective Treatment Option ◽  
Beneficial Effects ◽  
Migraine Frequency ◽  
Initial Session ◽  
Potential Alternative

Abstract BackgroundCurrent therapies for migraine have proven partially effective, highlighting the need for alternative treatment options. In this report, the authors conducted a single arm pilot exploratory study to evaluate the effect of Kiatsu with Ki training in adult females with episodic migraine.MethodsStudy subjects established a baseline migraine frequency over 4 weeks. During the following 4 weeks, each subject received instruction in Ki training (to improve concentration, balance, and relaxation), accompanied by Kiatsu (a focused touch method that reduces tension, swelling, and pain). Subjects then participated in one session a month for an additional 6 months. The initial session was 1 hour; subsequent sessions averaged 30 minutes. Subjects documented migraine frequency, migraine-specific quality of life scores, and medication use.ResultSixty-nine subjects met the study inclusion criteria and 21 completed the study. Subjects reported a significant reduction in migraine frequency after 1 month (from 7.2 to 3.8 migraines/month; p < 0.05), with an overall 53% reduction at 8 months (p < 0.001). Significant improvements in quality of life (QoL) were reported after 1 month, with continued improvements until study completion (p < 0.0001). A moderate reduction in medication use was also documented (p < 0.03), corresponding with improved QoL scores.ConclusionKiatsu with Ki training may be an effective treatment option for females with migraines, either in combination with medications or as a potential alternative to medications for patients who do not benefit from conventional therapies.

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