短暂性视觉障碍与无先兆偏头痛患者的残疾和自杀风险相关。

Transient visual disturbances are associated with disability and suicide risk in patients with migraine without aura.

机构信息

Keelung Hospital of the Ministry of Health and Welfare, Keelung, Taiwan, ROC.

Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2023 Jun 1;86(6):557-564. doi: 10.1097/JCMA.0000000000000912. Epub 2023 Mar 13.

DOI:10.1097/JCMA.0000000000000912

PMID:36907842

Abstract

BACKGROUND

To investigate the characteristics and clinical correlates of transient visual disturbances (TVDs) in patients with migraine without aura (MO). Patients with MO frequently report TVDs, which differ from typical visual aura, but the clinical significance of these TVDs has not been determined.

METHODS

Patients with MO who attended our headache clinics were enrolled. Structured questionnaires were used to acquire data on participants' headache profiles, disability, comorbidities, and lifetime suicidal ideation and suicide attempts. A semistructured visual phenomenon questionnaire was used to characterize TVDs. Headache specialists interviewed the participants for diagnosis and the verification of questionnaire responses.

RESULTS

Patients with MO (n = 7200; female/male ratio = 3.56, mean age 40.1 ± 13.4 years) were divided into two groups based on the presence (n = 2488) or absence (n = 4712) of TVDs. Patients with TVDs had more headache-related disability, psychiatric comorbidities, and photophobia than did those without TVDs. Suicidal ideation and suicide attempts were more common among patients with than among those without TVDs [ideation: odds ratio (OR) = 1.92, 95% confidence interval (CI) 1.71-2.15, p < 0.001; suicide attempt: OR = 2.23, 95% CI 1.80-2.75, p < 0.001].

CONCLUSION

The presence of TVDs may imply greater migraine-related disability, photophobia, and suicidal ideation/suicide attempt risk in patients with MO.

摘要

背景

本研究旨在探讨无先兆偏头痛（MO）患者短暂性视觉障碍（TVDs）的特征及其与临床相关因素的关系。MO 患者常报告有 TVDs，其不同于典型的视觉先兆，但这些 TVDs 的临床意义尚未确定。

方法

本研究纳入了在头痛诊所就诊的 MO 患者。采用结构化问卷收集患者的头痛特征、残疾状况、合并症以及终生自杀意念和自杀尝试的相关数据。采用半结构化的视觉现象问卷来描述 TVDs。头痛专家通过访谈患者来进行诊断并验证问卷的回答。

结果

MO 患者（n = 7200；女性/男性比例 = 3.56，平均年龄 40.1 ± 13.4 岁）根据是否存在 TVDs（n = 2488）或不存在 TVDs（n = 4712）分为两组。与无 TVDs 的患者相比，有 TVDs 的患者头痛相关残疾、精神合并症和畏光更为常见。有自杀意念和自杀尝试的患者比无自杀意念和自杀尝试的患者更为常见[有自杀意念：比值比（OR）= 1.92，95%置信区间（CI）为 1.71-2.15，p < 0.001；有自杀尝试：OR = 2.23，95% CI 为 1.80-2.75，p < 0.001]。