Delussi Marianna, Gentile Eleonora, Coppola Gianluca, Prudenzano Addolorata Maria Pia, Rainero Innocenzo, Sances Grazia, Abagnale Chiara, Caponnetto Valeria, De Cesaris Francesco, Frattale Ilaria, Guaschino Elena, Marcinnò Andrea, Ornello Raffaele, Pistoia Francesca, Putortì Alessia, Roca Maria Elena, Roveta Fausto, Lupi Chiara, Trojano Maria, Pierelli Francesco, Geppetti Pierangelo, Sacco Simona, de Tommaso Marina
Applied Neurophysiology and Pain Unit, Scienze Mediche di Base, Neuroscienze e Organi di Senso Department, Bari Aldo Moro University, Bari, Italy.
Sapienza University of Rome Polo Pontino, Latina, Italy.
Front Neurol. 2020 Nov 10;11:597881. doi: 10.3389/fneur.2020.597881. eCollection 2020.
Previous studies during SARS and Ebola pandemics have shown that quarantine is associated with several negative psychological effects, such as post-traumatic stress symptoms, confusion, and anger. These conditions may affect the course of many diseases, including migraine. Although it is possible that the quarantine measures for the current COVID-19 pandemic affect migraine burden, no information is currently available on this issue. In this study, we aimed to: (1) explore the possible changes in migraine frequency, severity, and days with acute medication intake during quarantine period; (2) evaluate possible differences in migraine outcomes in consideration of lifestyle changes, emotions, pandemic diffusion, and COVID-19 infection. We interviewed patients who were included in the observational Italian Headache Registry (Registro Italiano Cefalee, RICE), retrospectively collecting information on main headache features, lifestyle factors, emotions, individual infection status, and perception of COVID-19 for 2 months before (pre-quarantine) and after the beginning of the quarantine (quarantine). Inclusion criteria were: age > 18, diagnosis of migraine without aura, migraine with aura and chronic migraine, last in-person visit more than 3 months preceding the beginning of quarantine. A total of 433 migraine subjects agreed to be interviewed. We found an overall reduction in headache frequency (9.42 ± 0.43 days with headache vs. 8.28 ± 0.41) and intensity (6.57 ± 0.19 vs. 6.59 ± 0.21) during the quarantine, compared to pre-quarantine. There was a correlation between improvement and number of days of stay-at-home. When results were stratified for geographic area, we found a tendency toward worsening of headache frequency in northern Italy. Disgust regarding viral infection corresponded to a minor improvement in migraine. Migraine patients showed a mild improvement of migraine features, probably attributable to resilient behavior toward pandemic distress. Disgust regarding the contagion whereas potentially favoring defensive behavior, could potentially worsen migraine. The spontaneous limitation of migraine burden during quarantine could favor patient follow-up via the use of telemedicine visits, reliable diaries, and frequent remote contacts.
先前在非典和埃博拉疫情期间的研究表明，隔离会带来一些负面心理影响，如创伤后应激症状、困惑和愤怒。这些状况可能会影响包括偏头痛在内的多种疾病的病程。虽然当前新冠疫情的隔离措施有可能影响偏头痛负担，但目前尚无关于此问题的相关信息。在本研究中，我们旨在：（1）探究隔离期间偏头痛发作频率、严重程度以及服用急性药物天数的可能变化；（2）考虑生活方式改变、情绪、疫情传播和新冠病毒感染情况，评估偏头痛结果的可能差异。我们对纳入意大利头痛观察登记处（意大利头痛登记处，RICE）的患者进行了访谈，回顾性收集了隔离前（隔离前）和隔离开始后（隔离期）两个月内有关主要头痛特征、生活方式因素、情绪、个人感染状况以及对新冠病毒的认知等信息。纳入标准为：年龄大于18岁，无先兆偏头痛、有先兆偏头痛和慢性偏头痛的诊断，隔离开始前最后一次面诊时间超过3个月。共有433名偏头痛患者同意接受访谈。我们发现，与隔离前相比，隔离期间头痛频率（头痛天数：9.42±0.43天对8.28±0.41天）和强度（6.57±0.19对6.59±0.21）总体有所降低。改善情况与居家天数之间存在相关性。按地理区域分层分析结果时，我们发现意大利北部头痛频率有恶化趋势。对病毒感染的厌恶与偏头痛的轻微改善相对应。偏头痛患者的偏头痛特征有轻度改善，这可能归因于对疫情困扰的弹性行为。对传染的厌恶虽然可能有利于防御行为，但也可能使偏头痛恶化。隔离期间偏头痛负担的自发减轻可能有利于通过远程医疗问诊、可靠的日记记录和频繁的远程联系对患者进行随访。
