Spine Health Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara 06230, Türkiye.
Department of Clinical and Molecular Medicine, Sapienza University, 000189 Rome, Italy.
Toxins (Basel). 2022 Dec 30;15(1):29. doi: 10.3390/toxins15010029.
Neck disability and pain are frequently encountered problems in patients with chronic migraine (CM). The long-term stimuli of neurons in the trigeminocervical junction may explain this situation. OnabotulinumtoxinA (ONA) treatment is one of the proven treatments for CM; however, there is no study data on the efficacy of ONA treatment on neck disability and pain in CM patients. Therefore, we aimed to investigate the effect of ONA treatment on disability, neck pain and headache intensity in CM patients. One hundred thirty-four patients who met the inclusion criteria were included in the study. ONA treatment was administered at a dose of 195 U to 39 sites in total as per Follow-the-Pain PREEMPT protocol. The disability was evaluated with the Neck Disability Index and the Migraine Disability Assessment; pain intensity was evaluated with the Visual Analogue Scale; the monthly number of headache days were recorded; quality of life was evaluated with the Headache Impact Test. All assessments were recorded at baseline and 3 months after treatment. After the treatment, neck−migraine disabilities decreased from severe to mild for neck and moderate for migraine (p < 0.001). Neck pain and headache intensities decreased by almost half (p < 0.001). The median number of monthly headache days decreased from 20 days to 6 days (p < 0.000). The quality-of-life level decreased significantly from severe to substantial level (p < 0.001). According to our results, ONA treatment was effective in reducing neck-related problems in CM patients. Long-term follow-up results may provide researchers with more comprehensive results in terms of the treatment of chronic migraine−neck-related problems.
慢性偏头痛(CM)患者常出现颈部功能障碍和疼痛问题。三叉颈神经节神经元的长期刺激可能解释了这种情况。肉毒杆菌毒素 A(ONA)治疗是 CM 的一种已证实的治疗方法之一;然而,目前尚无关于 ONA 治疗对 CM 患者颈部功能障碍和疼痛疗效的研究数据。因此,我们旨在研究 ONA 治疗对 CM 患者颈部功能障碍、颈部疼痛和头痛强度的影响。本研究共纳入 134 名符合纳入标准的患者。根据 Follow-the-Pain PREEMPT 方案,ONA 治疗总剂量为 195U,共注射 39 个部位。采用颈部残疾指数和偏头痛残疾评估量表评估残疾程度;采用视觉模拟量表评估疼痛强度;记录每月头痛天数;采用头痛影响测试评估生活质量。所有评估均在基线和治疗后 3 个月进行。治疗后,颈部偏头痛残疾程度从严重降至轻度(颈部,p<0.001)和中度(偏头痛,p<0.001)。颈部疼痛和头痛强度几乎降低了一半(p<0.001)。每月头痛天数中位数从 20 天减少到 6 天(p<0.000)。生活质量水平从严重显著下降到中度(p<0.001)。根据我们的结果,ONA 治疗可有效减轻 CM 患者的颈部相关问题。长期随访结果可能为慢性偏头痛相关颈部问题的治疗提供更全面的结果。
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