1 Department of Preventive Medicine and Biometrics, affiliated with Uniformed Services University of Health Sciences, Bethesda, MD, USA.
2 Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Cephalalgia. 2019 Feb;39(2):296-305. doi: 10.1177/0333102418786266. Epub 2018 Jul 12.
To assess migraine epidemiology in men by examining gender differences in disease presentation, comorbidities, and prognosis.
The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study is a longitudinal survey of US adults with migraine identified by web questionnaire. Data were stratified by gender, collected between September 2012-November 2013, and included sociodemographics, headache features, Migraine Disability Assessment, Migraine Symptom Severity Score, Allodynia Symptom Checklist, and comorbidities. Discrete time hazard models addressed 1-year likelihood of transition from episodic to chronic migraine headache frequency.
Of the 16,789 migraine respondents, 4294 were men (25.6%). Compared to women, men were slightly older at onset of their headaches (mean 24.1 vs. 22.3 years) and had fewer headache days/month (4.3 vs. 5.3 days), slightly less severe attacks (Migraine Symptom Severity Score, 21.6 vs. 22.6), reduced frequencies of grade IV Migraine Disability Assessment scores (15.7% vs. 24.1%), allodynia (32.6% vs. 49.7%), chronic migraine (6.5% vs. 9.6%, each p < 0.001), and common comorbidities. Men were less likely to report consulting a doctor for their headaches and receiving a migraine diagnosis if they consulted. Men and women with episodic migraine had similar crude 1-year risk of chronic migraine onset. Controlling for known risk factors (i.e. depression, headache frequency, allodynia), men had greater likelihood of chronic migraine onset at 6, 9, and 12 months (each p < 0.05).
Findings confirmed gender differences. Men with migraine generally have less severe attacks and disability and are less likely to receive a diagnosis than women with migraine. Prognostic factors may be better understood for women than men.
通过研究疾病表现、合并症和预后方面的性别差异，评估男性偏头痛的流行病学情况。
慢性偏头痛流行病学和结局（CaMEO）研究是一项针对美国成年人偏头痛的纵向调查，通过网络问卷确定偏头痛患者。数据按性别分层，于 2012 年 9 月至 2013 年 11 月收集，包括社会人口统计学特征、头痛特征、偏头痛残疾评估、偏头痛症状严重程度评分、感觉异常症状检查表和合并症。离散时间风险模型分析了从偶发性偏头痛向慢性偏头痛头痛频率转变的 1 年可能性。
在 16789 名偏头痛应答者中，有 4294 名男性（25.6%）。与女性相比，男性偏头痛发作年龄稍大（平均 24.1 岁 vs. 22.3 岁），每月头痛天数较少（4.3 天 vs. 5.3 天），头痛发作程度稍轻（偏头痛症状严重程度评分，21.6 vs. 22.6），偏头痛残疾评估评分等级 IV 频率降低（15.7% vs. 24.1%），感觉异常发生率降低（32.6% vs. 49.7%），慢性偏头痛发生率降低（6.5% vs. 9.6%，均 p<0.001），常见合并症也减少。如果头痛咨询过医生，男性偏头痛患者就医和偏头痛诊断的可能性低于女性。偶发性偏头痛的男性和女性在 1 年内发生慢性偏头痛的风险相似。在控制已知风险因素（即抑郁、头痛频率、感觉异常）后，男性在 6、9 和 12 个月时发生慢性偏头痛的可能性更大（均 p<0.05）。
研究结果证实了性别差异。与女性偏头痛患者相比，男性偏头痛患者的头痛发作和残疾通常程度较轻，且不太可能被诊断为偏头痛。对于女性患者，可能比男性患者更能理解预后因素。
