Sastry Anand Sankar, Kumar Anand, Pathak Abhishek, Chaurasia R N, Singh Varun Kumar, Joshi Deepika, Singh Vineeta, Mishra Vijaya Nath
Department of Neurology, IMS, BHU, Varanasi, Uttar Pradesh, India.
Int J Neurosci. 2023 Dec;133(11):1262-1270. doi: 10.1080/00207454.2022.2075359. Epub 2022 Jun 13.
The aim of the study was to investigate the clinical profile, disease burden, quality of life, and treatment patterns of various headache subtypes.
In this prospective observational study, 815 patients presenting with chief complaints of headache between January 2020 to September 2021 were registered. After a detailed history, clinical examination, and subtyping, they were assessed at baseline with well-validated scales for severity (Visual Analogue Scale-VAS), disability burden (Migraine Disability Assessment- MIDAS), Humanistic burden (Headache Impact Test-HIT-6), and quality of life (World health organization-quality of life-WHO-QoL-8) scores. After initiating adequate management, parameters were reassessed at 3 and 6 months.
549 (67.7%) patients had migraine (395-episodic migraine, 144-chronic migraine), 266 (32.2%) patients had tension-type headache (TTH). Loss of sleep, prolonged working hours, and stress were common triggers. Disease burden, severity, and poor life quality was quite high in migraine patients (76.5% with moderate to severe disability, 61.7% with severe headache at onset, and 72% with poor life quality). All parameters had statistically significant improvement with preventive medication and lifestyle changes.
In our study, we found migraine was the most common primary headache followed by TTH. Migraine patients had more severity, disease burdens, and inferior quality of life at onset compared to other headaches. With early and proper diagnosis as well as preventive treatment (including lifestyle modifications), all parameters could be reversed positively in a brief time. This is the first study on headache burden and its effect on the quality of life in the north Indian population.
本研究的目的是调查各种头痛亚型的临床特征、疾病负担、生活质量和治疗模式。
在这项前瞻性观察研究中，登记了2020年1月至2021年9月期间以头痛为主诉的815例患者。经过详细的病史、临床检查和亚型分类后，在基线时使用经过充分验证的量表对他们进行严重程度（视觉模拟量表-VAS）、残疾负担（偏头痛残疾评估-MIDAS）、人文负担（头痛影响测试-HIT-6）和生活质量（世界卫生组织生活质量-WHO-QoL-8）评分评估。在开始适当的治疗后，在3个月和6个月时重新评估各项参数。
549例（67.7%）患者患有偏头痛（395例发作性偏头痛，144例慢性偏头痛），266例（32.2%）患者患有紧张型头痛（TTH）。睡眠不足、工作时间延长和压力是常见的诱发因素。偏头痛患者的疾病负担、严重程度和生活质量较差（76.5%有中度至重度残疾，61.7%起病时头痛严重，72%生活质量差）。所有参数在采用预防性药物治疗和改变生活方式后均有统计学意义的改善。
在我们的研究中，我们发现偏头痛是最常见的原发性头痛，其次是紧张型头痛。与其他头痛相比，偏头痛患者起病时的严重程度、疾病负担和生活质量较差。通过早期和正确的诊断以及预防性治疗（包括生活方式改变），所有参数在短时间内都可以得到积极改善。这是第一项关于印度北部人群头痛负担及其对生活质量影响的研究。
