Cavestro Cinzia, Prandi Giancarlo, Manildo Matteo, Martini Sabina, Genovesi Corrado, Premoli Alberto, Fraire Flavio, Neri Loris, Mandrino Silvia, Ferrero Marcella, Rota Eugenia
Headache Centre, Department of Neurology, ASL CN2, Alba, CN, Italy.
Department of Internal Medicine, S.S.D. Gastroenterology, ASL CN2, Alba, CN, Italy.
Neurol Sci. 2022 Oct;43(10):6031-6038. doi: 10.1007/s10072-022-06153-1. Epub 2022 May 28.
The relationship between chronic Helicobacter pylori (HP) infection and headache has been discussed for long; nevertheless, the results of the studies are still contrasting.
This cross-sectional study is aimed to investigate a possible association between HP and headache, mainly migraine.
We screened, by a self-administered questionnaire, the subjects undergoing a breath test or an esophagogastroduodenoscopy. Migraine was diagnosed according to the international criteria.
A total of 3914 patients underwent a breath test and 2200 an esophagogastroduodenoscopy at two hospitals, in Piedmont (Italy), in a 5-year period; a total of 1362 questionnaires were included in the study. The mean age of the subjects was 53 years; there were 777 women (57%). HP was detected in 364 (27%) subjects. A total of 702 (51%) subjects suffered from headache: migraine with aura was diagnosed in 176 subjects (176/702, i.e., 25% of the headache group; 176/1362, i.e., 13% of the total population); migraine without aura in 98 subjects (98/702, i.e., 14% of the headache group; 98/1362, i.e., 7% of the total). The logistic regression model did not detect any significant association between HP infection and headache, while a significant association between HP and headache frequency (p =0.009) was found, independently of age, gender, comorbidity, and diagnostic category.
Our study does not reveal an association between chronic HP infection and migraine. However, since HP is significantly associated with higher headache frequency, a role for HP as a risk factor for headache chronification, possibly underlain by inflammatory mechanisms, may be supposed.
幽门螺杆菌（HP）慢性感染与头痛之间的关系已被讨论良久；然而，研究结果仍存在争议。
本横断面研究旨在调查HP与头痛（主要是偏头痛）之间可能存在的关联。
我们通过自填问卷对接受呼气试验或食管胃十二指肠镜检查的受试者进行筛查。偏头痛根据国际标准进行诊断。
在意大利皮埃蒙特的两家医院，5年期间共有3914例患者接受了呼气试验，2200例接受了食管胃十二指肠镜检查；共有1362份问卷纳入研究。受试者的平均年龄为53岁；女性777例（57%）。364例（27%）受试者检测出HP。共有702例（51%）受试者患有头痛：176例受试者被诊断为伴有先兆的偏头痛（176/702，即头痛组的25%；176/1362，即总人口的13%）；98例受试者为无先兆偏头痛（98/702，即头痛组的14%；98/1362，即总人口的7%）。逻辑回归模型未检测到HP感染与头痛之间存在任何显著关联，而发现HP与头痛频率之间存在显著关联（p = 0.009），且独立于年龄、性别、合并症和诊断类别。
我们的研究未揭示慢性HP感染与偏头痛之间存在关联。然而，由于HP与较高的头痛频率显著相关，因此可以推测HP可能作为头痛慢性化的危险因素，其机制可能与炎症有关。
