Headache and Pain Unit, IRCCS San Raffaele Pisana, Rome, Italy.
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Neurol Sci. 2018 May;39(5):933-937. doi: 10.1007/s10072-018-3280-y. Epub 2018 Feb 22.
To optimize chronic migraine (CM) ascertainment and phenotype definition, provide adequate clinical management and health care procedures, and rationalize economic resources allocation, we performed an exploratory multicenter pilot study aimed at establishing a CM database, the first step for developing a future Italian CM registry. We enrolled 63 consecutive CM patients in four tertiary headache centers screened with face-to-face interviews using an ad hoc dedicated semi-structured questionnaire gathering detailed information on life-style, behavioral and socio-demographic factors, comorbidities, and migraine features before and after chronicization and healthcare resource use. Our pilot study provided useful insights revealing that CM patients (1) presented in most cases symptoms of peripheral trigeminal sensitization, a relatively unexpected feature which could be useful to unravel different CM endophenotypes and to predict trigeminal-targeted treatments' responsiveness; (2) had been frequently admitted to emergency departments; (3) had undergone, sometime repeatedly, unnecessary or inappropriate investigations; (4) got rarely illness benefit exemption or disability allowance only. We deem that the expansion of the database-shortly including many other Italian headache centers-will contribute to more precisely outline CM endophenotypes, hence improving management, treatment, and economic resource allocation, ultimately reducing CM burden on both patients and health system.
为了优化慢性偏头痛（CM）的确定和表型定义，提供充分的临床管理和医疗程序，并合理分配经济资源，我们进行了一项探索性的多中心试点研究，旨在建立一个 CM 数据库，这是未来意大利 CM 登记处的第一步。我们在四个三级头痛中心连续招募了 63 名 CM 患者，通过面对面访谈使用专门的半结构化问卷进行评估，该问卷收集了有关生活方式、行为和社会人口统计学因素、合并症以及慢性偏头痛前后的偏头痛特征和医疗资源使用情况的详细信息。我们的试点研究提供了有用的见解，表明 CM 患者（1）在大多数情况下表现出外周三叉神经敏化的症状，这是一个相对出乎意料的特征，可能有助于揭示不同的 CM 内表型，并预测针对三叉神经的治疗反应；（2）经常被送往急诊室；（3）有时会进行不必要或不适当的检查；（4）很少获得疾病津贴豁免或残疾津贴。我们认为，数据库的扩展——很快将包括许多其他意大利头痛中心——将有助于更准确地描绘 CM 的内表型，从而改善管理、治疗和经济资源分配，最终减轻 CM 对患者和医疗系统的负担。
