Pavlović Jelena M, Stewart Walter F, Bruce Christa A, Gorman Jennifer A, Sun Haiyan, Buse Dawn C, Lipton Richard B
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Montefiore Headache Center, Bronx, NY, USA.
J Headache Pain. 2015 Mar 18;16:24. doi: 10.1186/s10194-015-0503-y.
Studies of the difference between menstrually associated and non-menstrually associated migraine are somewhat controversial. The majority of studies have focused on comparing menstrual to non-menstrual attacks rather than comparing study groups with different migraine diagnoses with respect to menstruation. As there is limited knowledge available on the overall impact and burden of migraine among groups of women with and without menstrually associated migraine our goal was to examine differences between these groups. We hypothesized that there would be greater burden of migraine related to menstruation and headache frequency in a population study across groups of women.
We analyzed data from the American Migraine Prevalence and Prevention (AMPP) Study, a longitudinal, US, population-based study. We included female respondents to the 2009 survey, aged 18 to 60, who met modified ICHD-2 criteria for migraine, were actively menstruating and fit one of three definitions based on the self-reported association of menses and migraine attacks: self-reported predominantly menstrual migraine (MM, attacks that only or predominantly occur at the time of menses), self-reported menstrually-associated migraine (MAM, attacks commonly associated with menses, but that also occur at other times of the month), and self-reported menstrually-unrelated migraine (MUM). These three groups were compared on characteristics and measures of headache impact and burden (Headache Impact Test- 6 item (HIT-6) and Migraine Disability Assessment Scale (MIDAS).
There were 1,697 eligible subjects for this study in the following categories: MM (5.5%), MAM (53.8%), or MUM (40.7%). Women with MM had an older age of migraine onset. Those with predominantly menstrually-related attacks (MM) had fewer headache-days but appeared to be more impaired by attacks. HIT-6 and MIDAS scores were significantly higher for both the MM and MAM groups compared with the MUM groups; however, effects were more robust for MM than MAM.
Nearly 60% of women with migraine reported an association between migraine and menses. These women reported greater headache impact and migraine-related burden on functioning than those in whom migraines were not related to menstruation. Women with MM were more impaired by attacks while women with MAM had overall highest burden, likely due to experiencing migraines on additional days.
关于月经相关性偏头痛和非月经相关性偏头痛差异的研究存在一定争议。大多数研究集中于比较月经发作期与非月经发作期的偏头痛，而非比较不同偏头痛诊断类型的研究组在月经方面的差异。由于关于有或无月经相关性偏头痛的女性群体中偏头痛的总体影响和负担的现有知识有限，我们的目标是研究这些群体之间的差异。我们假设在一项针对女性群体的人群研究中，与月经相关的偏头痛负担和头痛频率会更大。
我们分析了来自美国偏头痛患病率与预防（AMPP）研究的数据，这是一项基于美国人群的纵向研究。我们纳入了2009年调查中年龄在18至60岁之间、符合改良国际头痛疾病分类第二版（ICHD - 2）偏头痛标准、处于活跃经期且根据自我报告的月经与偏头痛发作关联符合三种定义之一的女性受访者：自我报告为主要月经性偏头痛（MM，发作仅或主要发生在月经期间）、自我报告为月经相关性偏头痛（MAM，发作通常与月经相关，但也发生在每月的其他时间）以及自我报告为月经不相关偏头痛（MUM）。比较这三组在头痛影响和负担的特征及测量指标（头痛影响测试 - 6项（HIT - 6）和偏头痛残疾评估量表（MIDAS））方面的差异。
本研究有1697名符合条件的受试者，分为以下几类：MM（5.5%）、MAM（53.8%）或MUM（40.7%）。MM组女性偏头痛发病年龄较大。主要与月经相关发作的女性（MM）头痛天数较少，但发作似乎对其影响更大。与MUM组相比，MM组和MAM组的HIT - 6和MIDAS得分均显著更高；然而，MM组的影响比MAM组更强。
近60%的偏头痛女性报告偏头痛与月经有关。与偏头痛与月经无关的女性相比，这些女性报告的头痛影响和偏头痛相关的功能负担更大。MM组女性受发作影响更大，而MAM组女性总体负担最高，可能是因为在更多日子里经历偏头痛。
