Headache Unit, Department of Neurology, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.
Department of Neurology, Universidad Autónoma de Madrid, Madrid, Spain.
Pain Med. 2021 Sep 8;22(9):2079-2091. doi: 10.1093/pm/pnaa449.
Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine.
Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020.
We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress.
The response rate of the survey was 239/324 (73.8%). The final analysis included 222 subjects. Among them, 201/222 (90.5%) were women, aged 42.5 ± 12.0 (mean±SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0%), while worsening in 105/222 (47.3%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3%) and was related to symptoms of post-traumatic stress, older age and living with five or more people.
Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown.
先前的研究表明，情绪压力、生活方式习惯的改变和感染会使偏头痛的临床病程恶化。我们假设，在 2019 冠状病毒病（COVID-19）封锁期间，习惯和医疗保健的改变可能使偏头痛的临床病程恶化。
这是一项回顾性调查研究，从 2020 年 6 月至 7 月，在三家三级医院随访偏头痛患者的神经科医生，通过在线收集他们的反应。
我们使用了一个基于网络的调查，其中包括人口统计学数据、与任何头痛（频率）和偏头痛（主观恶化、频率和强度）相关的临床变量、封锁和创伤后应激症状。
该调查的回复率为 239/324（73.8%）。最终分析包括 222 名参与者。其中，201/222（90.5%）为女性，年龄 42.5±12.0（均值±标准差）。222 名参与者中有 31 名（14.0%）报告偏头痛在封锁期间有所改善，而 105 名（47.3%）则恶化，这与偏头痛诱因的改变有关，如与外出相关的压力和特定食物或饮料的摄入。222 名患者中有 67 名（30.2%）头痛发作的强度增加，这与主观恶化、女性、近期失眠和头痛期间使用急性药物有关。222 名患者中有 105 名（47.3%）每月头痛天数增加，这与创伤后应激症状、年龄较大和与 5 人或以上同住有关。
大约一半的偏头痛患者报告在封锁期间其常见疼痛恶化。偏头痛患者的临床病程恶化与触发因素的改变和封锁的情绪影响有关。
