Neurophysiopathology of Pain Unit, Neurological and Psychiatric Sciences Department, Medical Faculty, Policlinico General Hospital, Aldo Moro University, Neurological Building, Piazza Giulio Cesare 11, 70124, Bari, Italy.
J Headache Pain. 2011 Dec;12(6):629-38. doi: 10.1007/s10194-011-0377-6. Epub 2011 Aug 17.
Our previous study assessed the prevalence of fibromyalgia (FM) syndrome in migraine and tension-type headache. We aimed to update our previous results, considering a larger cohort of primary headache patients who came for the first time at our tertiary headache ambulatory. A consecutive sample of 1,123 patients was screened. Frequency of FM in the main groups and types of primary headaches; discriminating factor for FM comorbidity derived from headache frequency and duration, age, anxiety, depression, headache disability, allodynia, pericranial tenderness, fatigue, quality of life and sleep, and probability of FM membership in groups; and types of primary headaches were assessed. FM was present in 174 among a total of 889 included patients. It prevailed in the tension-type headache main group (35%, p < 0.0001) and chronic tension-type headache subtype (44.3%, p < 0.0001). Headache frequency, anxiety, pericranial tenderness, poor sleep quality, and physical disability were the best discriminating variables for FM comorbidity, with 81.2% sensitivity. Patients presenting with chronic migraine and chronic tension-type headache had a higher probability of sharing the FM profile (Bonferroni test, p < 0.01). A phenotypic profile where headache frequency concurs with anxiety, sleep disturbance, and pericranial tenderness should be individuated to detect the development of diffuse pain in headache patients.
我们之前的研究评估了纤维肌痛（FM）综合征在偏头痛和紧张型头痛中的患病率。我们旨在更新之前的结果，考虑到更多首次来到我们的三级头痛门诊的原发性头痛患者。对连续的 1123 名患者进行了筛查。主要头痛组中 FM 的频率和原发性头痛的类型；根据头痛频率和持续时间、年龄、焦虑、抑郁、头痛残疾、感觉异常、颅周压痛、疲劳、生活质量和睡眠得出的 FM 共病的鉴别因素，FM 在总共 889 名纳入患者中的 174 名患者中存在。它在紧张型头痛主要组（35%，p<0.0001）和慢性紧张型头痛亚组（44.3%，p<0.0001）中更为普遍。头痛频率、焦虑、颅周压痛、睡眠质量差和身体残疾是 FM 共病的最佳鉴别变量，敏感性为 81.2%。患有慢性偏头痛和慢性紧张型头痛的患者具有更高的共享 FM 特征的可能性（Bonferroni 检验，p<0.01）。应该确定一种表型特征，其中头痛频率与焦虑、睡眠障碍和颅周压痛一致，以检测头痛患者弥漫性疼痛的发展。
