Demiryurek Bekir Enes, Ertem Devrimsel Harika, Tekin Atilla, Ceylan Mustafa, Aras Yesim Guzey, Gungen Belma Dogan
Neurology Department, Sakarya University Education and Research Hospital, Sakarya, Turkey.
Algology Department, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Neurol Sci. 2016 Nov;37(11):1779-1784. doi: 10.1007/s10072-016-2665-z. Epub 2016 Jul 14.
Chronic migraine causes a serious labour loss and disability in the society and increases the risk of depression and anxiety by negatively affecting the quality of life. The purpose of this study was to investigate the effects of onabotulinumtoxinA (BoNT-A) treatment on efficacy before and after treatment in our cases with chronic migraine as well as on depression, anxiety and disability caused by migraine. According to the International Headache Classification (ICHD-III beta version), 60 adult patients who were diagnosed with chronic migraine were included in the study. A total of 155 IU BoNT-A treatment from 31 regions was administered in accordance with the protocol of PREEMPT study. Information about the characteristics of patients' headaches, background and family history, drugs they used was recorded. At the baseline and in the first and third month after the BoNT-A injection, VAS scores, the number of both headache days and attacks, the headache duration, the frequency of application to emergency services and the intake of both analgesics and triptans during attacks were evaluated. MIDAS, BDI and BAI were evaluated at the baseline and in the third month after the BoNT-A injection. BoNT-A injection provided a significant decrease in the number of days and severity of headaches, MIDAS disability scores and psychiatric complaints in cases with chronic migraine who did not respond to prophylactic treatments in the third month of the treatment.
慢性偏头痛在社会中导致严重的劳动力损失和残疾,并通过负面影响生活质量增加抑郁和焦虑风险。本研究的目的是调查在我们的慢性偏头痛病例中,A型肉毒毒素(BoNT-A)治疗对治疗前后疗效以及对偏头痛所致抑郁、焦虑和残疾的影响。根据国际头痛分类(ICHD-III beta版),60例被诊断为慢性偏头痛的成年患者纳入本研究。按照PREEMPT研究方案,从31个部位共注射155 IU BoNT-A进行治疗。记录患者头痛特征、背景和家族史、所用药物等信息。在BoNT-A注射的基线期、注射后的第1个月和第3个月,评估视觉模拟评分(VAS)、头痛天数和发作次数、头痛持续时间、急诊就诊频率以及发作期间镇痛药和曲坦类药物的使用情况。在BoNT-A注射的基线期和第3个月评估偏头痛残疾评估量表(MIDAS)、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)。在治疗的第3个月,BoNT-A注射使未对预防性治疗产生反应的慢性偏头痛患者的头痛天数和严重程度、MIDAS残疾评分以及精神症状显著降低。