Department of Neurology, NYU-MS Care Center, NYU School of Medicine, 301 E 17th St., New York, NY 10003, USA.
J Headache Pain. 2010 Oct;11(5):417-25. doi: 10.1007/s10194-010-0237-9. Epub 2010 Jul 13.
The objectives of this study were: (1) to assess relative frequency of migraine in multiple sclerosis (MS) patients using the validated self-administered diagnostic questionnaire, and to compare the migraine rates in MS outpatients to age- and gender-matched historical population controls; (2) to compare clinical and radiographic characteristics in MS patients with migraine and headache-free MS patients. We conducted a cross-sectional study to assess the demographic profiles, headache features and clinical characteristics of MS patients attending a MS clinic using a questionnaire based on the American Migraine Prevalence and Prevention (AMPP) study. We compared the relative frequency of migraine in MS clinic patients and AMPP cohort. We also compared clinical and radiographic features in MS patients with migraine to an MS control group without headache. Among 204 MS patients, the relative frequency of migraine was threefold higher than in population controls both for women [55.7 vs. 17.1%; prevalence ratio (PR) =3.26, p<0.001] and men (18.4 vs. 5.6%; PR=3.29, p<0.001). In a series of logistic regression models that controlled for age, gender, disease duration, β-interferon use, and depression, migraine in MS patients was significantly associated (p<0.01) with trigeminal and occipital neuralgia, facial pain, Lhermitte's sign, temporomandibular joint pain, non-headache pain and a past history of depression. Migraine status was not significantly associated with disability on patient-derived disability steps scale or T2 lesion burden on brain MRI. Migraine is three-times more common in MS clinic patients than in general population. MS-migraine group was more symptomatic than the MS-no headache group.
（1）使用经过验证的自我管理诊断问卷评估多发性硬化症（MS）患者偏头痛的相对频率，并将 MS 门诊患者的偏头痛发生率与年龄和性别匹配的历史人群对照进行比较；（2）比较偏头痛和无头痛 MS 患者的临床和影像学特征。我们进行了一项横断面研究，使用基于美国偏头痛患病率和预防（AMPP）研究的问卷评估了在 MS 诊所就诊的 MS 患者的人口统计学特征、头痛特征和临床特征。我们比较了 MS 诊所患者和 AMPP 队列中偏头痛的相对频率。我们还比较了偏头痛 MS 患者与无头痛 MS 对照组的临床和影像学特征。在 204 名 MS 患者中，女性偏头痛的相对频率是人群对照的三倍（55.7%比 17.1%；患病率比（PR）=3.26，p<0.001），男性偏头痛的相对频率是人群对照的三倍（18.4%比 5.6%；PR=3.29，p<0.001）。在一系列控制年龄、性别、疾病持续时间、β-干扰素使用和抑郁的逻辑回归模型中，MS 患者偏头痛与三叉神经痛和枕神经痛、面部疼痛、Lhermitte 征、颞下颌关节疼痛、非头痛性疼痛和既往抑郁史显著相关（p<0.01）。偏头痛状态与患者残疾评分或脑 MRI 上 T2 病变负担的残疾程度无显著相关性。偏头痛在 MS 诊所患者中的发生率是普通人群的三倍。MS-偏头痛组比 MS-无头痛组症状更明显。
