Neurological Headache Centre, S. Andrea Hospital, Sapienza University, Via di Grottarossa, 1035-00189, Rome, Italy.
Neurol Sci. 2012 Dec;33(6):1345-53. doi: 10.1007/s10072-012-1119-5. Epub 2012 May 27.
A high co-morbidity between multiple sclerosis (MS) and migraine has been reported, especially in young female patients affected by a relapsing-remitting (RR) course of MS. In this study, we aimed to elucidate the determinants of the severity of comorbid migraine in MS. Demographic, clinical and psychometric variables were collected from a cohort of 205 RR-MS patients regularly attending to an Italian outpatient MS Centre. Of them, 102 (49.8 %) were diagnosed as affected by comorbid migraine. About one-third of MS patients with comorbid migraine have asked the attending neurologist a specific anti-migraine treatment. Despite this, only few MS patients (10.8 %) reported a prior use of prophylactic drugs, and even fewer (2.9 %) took triptans as pain killers; these proportions were significantly lower when compared with those of a control group of 63 migraineurs subjects without MS (p < 0.0001 for both comparison). Factors associated with a moderate or severe disability (MIDAS grades III or IV) due to comorbid migraine in MS patients were the depressive state (OR = 4.294; p = 0.001), the anxiety trait (OR = 5.786; p = 0.004) and an ongoing IFNB treatment (OR = 2.337; p = 0.028). Likewise, depression (OR = 3.453; p = 0.048) and anxiety (OR = 4.582; p = 0.014) were both independent predictors for having a MIDAS grades of III or IV also in migraineurs subjects without MS. Investigating the determinants of migraine severity may allow a better management of MS patients with comorbid migraine. In these patients, a tailored therapeutic approach is warranted to improve their quality of life and reduce the burden of these two chronic and disabling conditions.
多发性硬化症（MS）与偏头痛之间存在高度共病性，特别是在患有复发缓解（RR）型 MS 的年轻女性患者中。在这项研究中，我们旨在阐明 MS 合并偏头痛严重程度的决定因素。我们从定期就诊于意大利门诊 MS 中心的 205 名 RR-MS 患者中收集了人口统计学、临床和心理计量学变量。其中，102 名（49.8%）患者被诊断为合并偏头痛。大约三分之一的 MS 合并偏头痛患者曾向主治神经内科医生询问过专门的偏头痛治疗方法。尽管如此，只有少数 MS 患者（10.8%）报告曾使用预防性药物，而更少的 MS 患者（2.9%）使用曲坦类药物作为止痛药；与没有 MS 的 63 名偏头痛对照组相比，这些比例显著较低（p<0.0001 两种比较）。与 MS 患者因合并偏头痛而导致中度或重度残疾（MIDAS 等级 III 或 IV）相关的因素包括抑郁状态（OR=4.294；p=0.001）、焦虑特质（OR=5.786；p=0.004）和正在进行的 IFNB 治疗（OR=2.337；p=0.028）。同样，抑郁（OR=3.453；p=0.048）和焦虑（OR=4.582；p=0.014）也是没有 MS 的偏头痛对照组中 MIDAS 等级为 III 或 IV 的独立预测因素。研究偏头痛严重程度的决定因素可能有助于更好地管理合并偏头痛的 MS 患者。在这些患者中，需要采用个性化治疗方法来改善他们的生活质量，并减轻这两种慢性和致残性疾病的负担。
