Mayo Clinic, Department of Neurology, Phoenix, AZ, USA.
University of Southern California, Department of Neurology, Los Angeles, CA, USA.
Cephalalgia. 2021 Sep;41(10):1053-1064. doi: 10.1177/03331024211006903. Epub 2021 May 2.
"Pain interference" and "headache impact" refer to negative consequences that pain and headache have on one's life. This study investigated determinants of these negative impacts in a large patient cohort who have chronic migraine with medication overuse.
Six hundred and eleven adults were enrolled from 34 headache, neurology, and primary care clinics. Negative consequences of chronic migraine with medication overuse were determined using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference 6b questionnaire and the Headache Impact Test 6. Relationships between PROMIS-6b and Headache Impact Test 6 scores with demographics, headache characteristics, medication use, anxiety symptoms, and depression symptoms were assessed with linear regression. Elastic Net regression was used to develop a multiple regression model.
PROMIS-6b T-Scores averaged 65.2 (SD 5.4) and Headache Impact Test 6 scores averaged 65.0 (SD 5.3), indicating severe negative consequences of chronic migraine with medication overuse. Chronic migraine with medication overuse interfered with enjoyment of life, concentration, daily activities, doing tasks away from home, and socializing. Depression symptom severity had the strongest relationship with pain interference and headache impact. Moderate-to-severe headache frequency, headache intensity, and anxiety symptoms were also associated with pain interference and headache impact.
Chronic migraine with medication overuse is associated with substantial negative consequences, the extent of which is most strongly related to depression symptoms.
“疼痛干扰”和“头痛影响”是指疼痛和头痛对生活造成的负面影响。本研究调查了患有药物过度使用性慢性偏头痛的大量患者群体中这些负面影响的决定因素。
从 34 家头痛、神经病学和初级保健诊所招募了 611 名成年人。使用患者报告的结果测量信息系统（PROMIS）疼痛干扰 6b 问卷和头痛影响测试 6 来确定药物过度使用性慢性偏头痛的负面后果。使用线性回归评估 PROMIS-6b 和头痛影响测试 6 评分与人口统计学、头痛特征、药物使用、焦虑症状和抑郁症状之间的关系。使用弹性网络回归开发多回归模型。
PROMIS-6b T 评分平均为 65.2（SD 5.4），头痛影响测试 6 评分平均为 65.0（SD 5.3），表明药物过度使用性慢性偏头痛的严重负面影响。药物过度使用性慢性偏头痛干扰了生活乐趣、注意力、日常活动、离家活动和社交。抑郁症状严重程度与疼痛干扰和头痛影响的关系最强。中度至重度头痛频率、头痛强度和焦虑症状也与疼痛干扰和头痛影响有关。
药物过度使用性慢性偏头痛与严重的负面影响相关，其程度与抑郁症状最相关。
