Giannini Giulia, Zanigni Stefano, Grimaldi Daniela, Melotti Roberto, Pierangeli Giulia, Cortelli Pietro, Cevoli Sabina
J Headache Pain. 2013 Jun 10;14(1):49. doi: 10.1186/1129-2377-14-49.
Cephalalgiaphobia is the fear of having a headache attack during a pain-free period that may induce patients to use analgesic in the absence of pain to prevent headache and to improve their performances. This study aims at assessing if cephalalgiaphobia is related to migraine frequency or medication overuse, and if it is per se a predictor of increase in migraine frequency.
This is a pilot prospective cohort study on 126 consecutive migraineurs referred to a tertiary Headache Centre. A headache specialist collected data regarding migraine features, frequency and medications at baseline (T0) and 2 years later (T1). Cephalalgiaphobia was investigated at T0 and T1 through a score determined by a 4 items questionnaire.
Moderate-high migraine frequency was associated with higher risk of cephalalgiaphobia (p < 0.001). Chronic migraineurs with medication overuse had higher score of cephalalgiaphobia than those without medication overuse (p < 0.001). Patients with increased migraine frequency between T0 and T1 had higher cephalalgiaphobia score (p < 0.001).
Cephalalgiaphobia may represent a high-frequency migraine feature and may play a role in chronicization. Therefore, it should be better investigated by clinicians and treated or prevented in order to reduce the risk of disability and the increase in migraine frequency.
头痛恐惧症是指在无痛期担心会发作头痛，这可能导致患者在没有疼痛时使用镇痛药来预防头痛并改善其状态。本研究旨在评估头痛恐惧症是否与偏头痛发作频率或药物过度使用有关，以及它本身是否是偏头痛发作频率增加的一个预测因素。
这是一项针对连续转诊至三级头痛中心的126例偏头痛患者的前瞻性队列试验研究。一名头痛专家收集了患者在基线时（T0）和2年后（T1）偏头痛特征、发作频率和用药情况的数据。在T0和T1时通过一份由4个项目组成的问卷所确定的评分来调查头痛恐惧症。
中高偏头痛发作频率与更高的头痛恐惧症风险相关（p < 0.001）。药物过度使用的慢性偏头痛患者的头痛恐惧症评分高于未过度使用药物的患者（ p < 0.001）。在T0和T1之间偏头痛发作频率增加的患者头痛恐惧症评分更高（p < 0.001）。
头痛恐惧症可能是偏头痛的一个高频特征，并且可能在慢性化过程中起作用。因此，临床医生应更好地对其进行研究，并进行治疗或预防，以降低致残风险和偏头痛发作频率的增加。
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