Wang Jiawei, Zhang Bingren, Shen Chanchan, Zhang Jinhua, Wang Wei
Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou, China.
BMC Neurol. 2017 Oct 12;17(1):193. doi: 10.1186/s12883-017-0973-4.
Headache symptoms self-reported by migraine patients are largely congruent with the clinician-used diagnostic criteria, but not always so. Patients' self-reports of headache symptoms might offer additional clues to characterize migraine with (MA) and without (MO) aura more precisely.
Firstly, we invited 324 participants with a life-long headache attack to answer an item-matrix measuring symptoms of primary headaches, then we performed both exploratory and confirmatory factor analyses to their answers and refined a headache symptom questionnaire. Secondly, we applied this questionnaire to 28 MA and 52 MO patients.
In participants with a life-long headache, we refined a 27-item, structure-validated headache symptom questionnaire, with four factors (scales) namely the Somatic /Aura Symptoms, Gastrointestinal and Autonomic Symptoms, Tightness and Location Features, and Prodromal/Aggravating Symptoms. Further, we found that MA patients reported higher than did MO patients on the Somatic/Aura Symptoms and Tightness and Location Features scales.
Compared to MO, MA was conferred with more prominent tightness and location features besides its higher somatic or aura symptoms. Patients' self-reports of headache symptoms might offer more clues to distinguish two types of migraine besides their clinician-defined criteria.
偏头痛患者自我报告的头痛症状在很大程度上与临床医生使用的诊断标准一致，但并非总是如此。患者对头痛症状的自我报告可能会提供额外线索，以便更精确地对伴有（MA）和不伴有（MO）先兆的偏头痛进行特征描述。
首先，我们邀请了324名有终身头痛发作史的参与者回答一份测量原发性头痛症状的项目矩阵，然后对他们的回答进行探索性和验证性因素分析，并完善了一份头痛症状问卷。其次，我们将这份问卷应用于28名MA患者和52名MO患者。
在有终身头痛史的参与者中，我们完善了一份包含27个项目、结构有效的头痛症状问卷，该问卷有四个因素（量表），即躯体/先兆症状、胃肠道和自主神经症状、紧绷感和位置特征，以及前驱/加重症状。此外，我们发现MA患者在躯体/先兆症状以及紧绷感和位置特征量表上的得分高于MO患者。
与MO相比，MA除了有更高的躯体或先兆症状外，还具有更明显的紧绷感和位置特征。患者对头痛症状的自我报告可能会提供更多线索，以区分两种类型的偏头痛，而不仅仅是临床医生定义的标准。
