Vincent Maurice, Viktrup Lars, Nicholson Robert A, Ossipov Michael H, Vargas Bert B
Eli Lilly and Company, Indianapolis, IN, United States.
Evidera, Bethesda, MD, United States.
Front Neurol. 2022 Nov 3;13:1032103. doi: 10.3389/fneur.2022.1032103. eCollection 2022.
Migraine is a highly prevalent neurological disease of varying attack frequency. Headache attacks that are accompanied by a combination of impact on daily activities, photophobia and/or nausea are most commonly migraine. The headache phase of a migraine attack has attracted more research, assessment tools and treatment goals than any other feature, characteristic, or phase of migraine. However, the migraine attack may encompass up to 4 phases: the prodrome, aura, headache phase and postdrome. There is growing recognition that the burden of migraine, including symptoms associated with the headache phase of the attack, may persist between migraine attacks, sometimes referred to as the "interictal phase." These include allodynia, hypersensitivity, photophobia, phonophobia, osmophobia, visual/vestibular disturbances and motion sickness. Subtle interictal clinical manifestations and a patient's trepidation to make plans or commitments due to the unpredictability of migraine attacks may contribute to poorer quality of life. However, there are only a few tools available to assess the interictal burden. Herein, we examine the recent advances in the recognition, description, and assessment of the interictal burden of migraine. We also highlight the value in patients feeling comfortable discussing the symptoms and overall burden of migraine when discussing migraine treatment needs with their provider.
偏头痛是一种发作频率各异的高度常见的神经系统疾病。伴有对日常活动产生影响、畏光和/或恶心等多种症状的头痛发作最常见的是偏头痛。与偏头痛的任何其他特征、特性或阶段相比，偏头痛发作的头痛期吸引了更多的研究、评估工具和治疗目标。然而，偏头痛发作可能包括多达4个阶段：前驱期、先兆期、头痛期和头痛后期。人们越来越认识到，偏头痛的负担，包括与发作头痛期相关的症状，可能在偏头痛发作之间持续存在，有时被称为“发作间期”。这些症状包括痛觉过敏、超敏反应、畏光、畏声、畏渗透压、视觉/前庭障碍和晕动病。发作间期的细微临床表现以及患者因偏头痛发作的不可预测性而对制定计划或做出承诺的恐惧，可能会导致生活质量下降。然而，目前只有少数工具可用于评估发作间期的负担。在此，我们探讨了在偏头痛发作间期负担的识别、描述和评估方面的最新进展。我们还强调了患者在与医疗服务提供者讨论偏头痛治疗需求时，能够自在地谈论偏头痛症状和总体负担的重要性。
