偏头痛与哈欠。

Migraine and Yawning.

机构信息

Department of Neurology, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

出版信息

Headache. 2018 Feb;58(2):210-216. doi: 10.1111/head.13195. Epub 2017 Sep 27.

DOI:10.1111/head.13195

PMID:28960327

Abstract

BACKGROUND

Yawning is considered to be a symptom that reflects dopaminergic activity, although its pathophysiological mechanism is not yet fully understood. Interestingly, repetitive yawning is seen in some patients during migraine attacks. The aim of this cross-sectional study is to investigate the frequency of yawning during migraine attacks and its association with different characteristics of migraine.

METHODS

Patients with migraine with or without aura were evaluated using questionnaires and diaries to determine the characteristics of headache and accompanying symptoms. Repetitive yawning in the premonitory phase and/or during headache were determined.

RESULTS

Three hundred and thirty-nine patients were included in the study. One hundred and fifty-four patients reported repetitive yawning (45.4%) during migraine attacks. Repetitive yawning was reported in the 11.2% of the patients in the premonitory phase, 24.2% during headaches, and 10% both in the premonitory phase and during headaches. Migraine with aura (46.8 vs 31.9%; P = .005), accompanying nausea (89.6 vs 75.1%; P = .001), vomiting (48.7 vs 37.8%; P = .044), osmophobia (66.7 vs 52.3%; P = .024), and cutaneous allodynia (58.2 vs 46%; P = .032) were more common in patients with yawning than without. Other dopaminergic-hypothalamic premonitory symptoms (41.6 vs 26.5%; P = .003), especially sleepiness (17.5 vs 5.9%; P = .001), irritability/anxiety (21.4% vs 11.4%; P = .019), nausea/vomiting (10.4 vs 4.3%; P = .03), and changes in appetite (18.2 vs 9.7%; P = .024), were also more frequent in patients with yawning than without. After being adjusted for all other relevant covariates, the odds of repetitive yawning were increased by the presence of nausea (OR 2.88; 95% CI 1.453-5.726; P = .002) and migraine with aura (OR 1.66; 95% CI 1.035-2.671; P = .036).

CONCLUSIONS

Our results demonstrated that yawning is a common self-reported symptom leading or accompanying migraine attacks and is associated with aura, nausea and/or vomiting, osmophobia, and cutaneous allodynia in patients with migraine. Although yawning is a rather frequently seen behavior, it is a unique and reliable symptom in patients with migraine that may offer an opportunity for early treatment of migraine attacks.

摘要

背景

打哈欠被认为是反映多巴胺能活动的症状，尽管其病理生理机制尚未完全了解。有趣的是，一些偏头痛患者在偏头痛发作期间会出现重复性打哈欠。本横断面研究的目的是调查偏头痛发作期间打哈欠的频率及其与偏头痛不同特征的关系。

方法

使用问卷和日记评估偏头痛伴或不伴先兆的患者，以确定头痛和伴随症状的特征。确定先兆期和/或头痛期间重复性打哈欠的情况。

结果

本研究纳入了 339 名患者。154 名患者（45.4%）报告在偏头痛发作期间出现重复性打哈欠。在先兆期报告有重复性打哈欠的患者占 11.2%，在头痛期报告有重复性打哈欠的患者占 24.2%，在先兆期和头痛期均报告有重复性打哈欠的患者占 10%。有先兆偏头痛（46.8% vs 31.9%；P=0.005）、伴随恶心（89.6% vs 75.1%；P=0.001）、呕吐（48.7% vs 37.8%；P=0.044）、嗅觉过敏（66.7% vs 52.3%；P=0.024）和皮肤触诱发痛（58.2% vs 46%；P=0.032）的患者中打哈欠更为常见。其他多巴胺能-下丘脑先兆症状（41.6% vs 26.5%；P=0.003），尤其是嗜睡（17.5% vs 5.9%；P=0.001）、烦躁/焦虑（21.4% vs 11.4%；P=0.019）、恶心/呕吐（10.4% vs 4.3%；P=0.03）和食欲改变（18.2% vs 9.7%；P=0.024）在打哈欠的患者中也更为常见。在调整所有其他相关协变量后，恶心（比值比 2.88；95%置信区间 1.453-5.726；P=0.002）和有先兆偏头痛（比值比 1.66；95%置信区间 1.035-2.671；P=0.036）的存在使重复性打哈欠的可能性增加。