瑞典双胞胎人群样本中复发性原发性头痛的终生患病率及特征

Lifetime prevalence and characteristics of recurrent primary headaches in a population-based sample of Swedish twins.

作者信息

Svensson Dan A, Ekbom Karl, Larsson Bo, Waldenlind Elisabet

机构信息

Division of Neurology, Neurotec, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden.

出版信息

Headache. 2002 Sep;42(8):754-65. doi: 10.1046/j.1526-4610.2002.02177.x.

DOI:10.1046/j.1526-4610.2002.02177.x

PMID:12390638

Abstract

OBJECTIVE

To examine the lifetime prevalence and other characteristics of recurrent primary headaches in twins.

BACKGROUND

The twin model may provide insights into the role of genetic and environmental influences in headache disorders. However, assumptions as to whether twins are representative of the general population, and whether monozygotic and dizygotic twins are similar have rarely been addressed.

METHODS

The study population consisted of a random sample of 17- to 82-year-old twins from the Swedish Twin Registry (n = 1329). Structured interviews on the telephone by lay personnel and the International Headache Society criteria were used for assessment and diagnosis of recurrent primary headaches. Prevalence data of the general population for migraine and tension-type headache was obtained from various published reports.

RESULTS

A total of 372 subjects (29%) had ever had recurrent headaches. In total, 241 recurrent headache sufferers fulfilled the criteria for migraine or tension-type headache, and the lifetime prevalence was 7.1% for migraine without aura, 1.4% for migraine always with aura, 1.9% for migraine occasionally with aura, 9.4% for episodic tension-type headache, and 1.3% for chronic tension-type headache. The lifetime prevalence of all migraine and all tension-type headache, including another 84 subjects fulfilling all but one of the criteria for migraine or tension-type headache, was 13.8% and 13.5%, respectively. The corresponding prevalence risk for women was 2.4 (95% confidence interval [CI] 1.7, 3.4) and 1.5 (95% CI 1.1, 2.1), respectively. Zygosity was not a significant predictor for migraine. In tension-type headache, the prevalence risk for dizygotic twins and unlike-sexed twins as compared with monozygotic twins was 1.9 (95% CI: 1.2, 3.1) and 1.8 (95% CI: 1.1, 2.9), respectively.

CONCLUSION

There is no twin-singleton or monozygotic-dizygotic difference for the risk of migraine. In tension-type headache, twins seem to have a lower risk than singletons, and this is especially true for monozygotic twins.

摘要

目的

研究双胞胎中复发性原发性头痛的终生患病率及其他特征。

背景

双胞胎模型有助于深入了解遗传和环境因素在头痛疾病中的作用。然而，关于双胞胎是否能代表一般人群，以及同卵双胞胎和异卵双胞胎是否相似的假设，此前很少有人探讨。

方法

研究人群为从瑞典双胞胎登记处随机抽取的17至82岁双胞胎（n = 1329）。由非专业人员通过电话进行结构化访谈，并依据国际头痛协会标准对复发性原发性头痛进行评估和诊断。偏头痛和紧张型头痛的一般人群患病率数据来自各种已发表的报告。

结果

共有372名受试者（29%）曾患复发性头痛。总计241名复发性头痛患者符合偏头痛或紧张型头痛的标准，无先兆偏头痛的终生患病率为7.1%，总是有先兆偏头痛为1.4%，偶尔有先兆偏头痛为1.9%，发作性紧张型头痛为9.4%，慢性紧张型头痛为1.3%。所有偏头痛和所有紧张型头痛的终生患病率（包括另外84名符合偏头痛或紧张型头痛所有标准但有一项不符的受试者）分别为13.8%和13.5%。女性相应的患病风险分别为2.4（95%置信区间[CI] 1.7, 3.4）和1.5（95% CI 1.1, 2.1）。双胞胎类型不是偏头痛的显著预测因素。在紧张型头痛中，与同卵双胞胎相比，异卵双胞胎和不同性别的双胞胎的患病风险分别为1.9（95% CI: 1.2, 3.1）和1.8（95% CI: 1.1, 2.9）。