Department of Pathophysiology, Showa University School of Pharmacy, Tokyo 142-8555, Japan.
Neurol Sci. 2013 Jan;34(1):85-92. doi: 10.1007/s10072-012-0955-7.
Migraine patients are particularly prone to develop medication overuse headache (MOH). However, the risk factors for the transformation of migraine to MOH are still not clear. We investigated gene polymorphisms, personality traits, and characteristics of headache and lifestyle in 47 migraine patients (aged 36.4 ± 10.3) and 22 MOH patients (aged 39.6 ± 9.9) who progressed from migraine and made a scoring system for a predictive index (PI) of the onset of MOH in patients with migraine. By multivariate logistic stepwise regression analysis, type of migraine, regular and sufficient dietary intake, and methylenetetrahydrofolate reductase (MTHFR) C677T (rs1801133) and dopamine D2 receptor (DRD2) C939T (rs6275) polymorphisms were selected as significant factors that contribute independently to the development from migraine to MOH (P < 0.05). The regression coefficients (β) of these four selected factors were approximated and scored. The PI score in MOH patients (7.32 ± 1.60) was significantly higher than that in migraine patients (4.62 ± 1.83, P < 0.001). The proposed scoring system should in the future be the object of larger studies to confirm its validity.
偏头痛患者特别容易发展为药物过度使用性头痛（MOH）。然而，偏头痛向 MOH 转化的危险因素仍不清楚。我们调查了 47 名偏头痛患者（年龄 36.4±10.3）和 22 名 MOH 患者（年龄 39.6±9.9）的基因多态性、人格特质、头痛特征和生活方式，这些患者都从偏头痛进展而来。我们建立了偏头痛患者发生 MOH 的预测指数（PI）评分系统。通过多变量逻辑逐步回归分析，选择偏头痛类型、规律和充足的饮食摄入以及亚甲基四氢叶酸还原酶（MTHFR）C677T（rs1801133）和多巴胺 D2 受体（DRD2）C939T（rs6275）多态性作为独立导致偏头痛向 MOH 发展的重要因素（P<0.05）。对这四个选定因素的回归系数（β）进行了近似和评分。MOH 患者的 PI 评分（7.32±1.60）明显高于偏头痛患者（4.62±1.83，P<0.001）。该评分系统应在未来进行更大规模的研究以确认其有效性。
