Neumeier Maria Susanne, Pohl Heiko, Sandor Peter S, Gut Hans, Merki-Feld Gabriele S, Andrée Colette
Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland.
Zurzach Care, 5330 Bad Zurzach, Switzerland.
Brain Sci. 2021 Oct 5;11(10):1323. doi: 10.3390/brainsci11101323.
The aim of this study was to investigate sex differences in the burden of migraine and tension-type headache (TTH).
Migraine and TTH are more common in women than in men, with differences in comorbidities, treatment responses, disease-modifying factors, and ictal and interictal burden of disease. Information about sex-related influences on ictal and interictal burden is limited, and an increased understanding is mandatory to provide tailored individual treatment for female and male patients.
Participants answered an online survey based on the EUROLIGHT questionnaire. Inclusion criteria were the consent to participate, complete responses to the diagnostic questions, and information about their sex. Sex differences were investigated using the Mann-Whitney U test or Chi-square test. For detecting factors that influence the burden of disease, we built binary regression models.
We included 472 (74.6% female) migraineurs and 161 (59.6% female) participants with TTH. Women with migraine reported significantly more problems in their love lives, more self-concealment, less feelings of being understood by family and friends, more interictal anxiety, a higher pain severity, and more depression and anxiety symptoms than men. For TTH, we did not find significant sex-related differences. A higher headache frequency was the factor that increased the burden of disease in female but not in male migraneurs.
The burden of disease was higher in women than men with migraine in many aspects, but not with TTH. Therefore, according to our results, there is a need for sex-specific precision medicine for migraine but not TTH. Controlling the headache frequency with a proper acute or prophylactic treatment and treating comorbid depression and anxiety symptoms is crucial to ease migraine's burden, especially in women.
本研究旨在调查偏头痛和紧张型头痛（TTH）负担方面的性别差异。
偏头痛和TTH在女性中比在男性中更常见，在合并症、治疗反应、疾病修饰因素以及发作期和发作间期的疾病负担方面存在差异。关于性别对发作期和发作间期负担的影响的信息有限，因此有必要加深了解，以便为女性和男性患者提供个性化的治疗。
参与者根据EUROLIGHT问卷回答在线调查。纳入标准为同意参与、对诊断问题的完整回答以及有关其性别的信息。使用曼-惠特尼U检验或卡方检验研究性别差异。为了检测影响疾病负担的因素，我们建立了二元回归模型。
我们纳入了472名偏头痛患者（74.6%为女性）和161名TTH患者（59.6%为女性）。与男性相比，患有偏头痛的女性在爱情生活中报告的问题明显更多，更多自我隐瞒，感觉被家人和朋友理解的程度更低，发作间期焦虑更多，疼痛严重程度更高，抑郁和焦虑症状更多。对于TTH，我们未发现显著的性别相关差异。较高的头痛频率是增加女性偏头痛患者疾病负担的因素，但对男性偏头痛患者则不然。
在许多方面，偏头痛女性患者的疾病负担高于男性，但TTH并非如此。因此，根据我们的研究结果，偏头痛需要针对性别制定精准医学方案，而TTH则不需要。通过适当的急性或预防性治疗控制头痛频率以及治疗合并的抑郁和焦虑症状对于减轻偏头痛负担至关重要，尤其是对女性而言。
