Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy.
Clinical Neurophysiology Unit, Sleep Lab, "Clinical Course", 90143 Palermo, Italy.
Toxins (Basel). 2023 Aug 27;15(9):527. doi: 10.3390/toxins15090527.
Chronic migraine is a burdensome condition, and onabotulinumtoxinA is revealed to be an effective therapy. Migraine shows a bidirectional relationship with sleep, but the effects of preventive therapies on sleep quality are poorly studied. This study aims to evaluate the effects of a single session of onabotulinumtoxinA on patients' sleep quality and correlates the results with measures of comorbid anxiety/depression. Patients completed self-administrable questionnaires about sleep quality (Pittsburgh Sleep Quality Index-PSQI) and psychological symptoms (Beck Depression Inventory, 2nd edition-BDI-II-and Hospital Anxiety and Depression Scale-HADS-subscales "a" and "d" for anxiety and depression, respectively), and reported migraine frequency at baseline and after 12 weeks. The 42 included patients showed a significant reduction in migraine days (from 20.6 ± 6.0 to 13.6 ± 6.2, < 0.001), while no changes were observed in sleep quality (PSQI score from 11.0 ± 5.0 to 9.8 ± 4.6, = 0.277) or psychological measures (BDI-II from 16.7 ± 10.2 to 15.7 ± 10.3, = 0.678; HADS-a from 10.3 ± 4.8 to 9.3 ± 5.5, = 0.492; and HADS-d from 7.2 ± 3.9 to 7.1 ± 5.0, = 0.901). On the other hand, a strong correlation among PSQI, BDI-II, HADS-a, and HADS-d scores ( < 0.001, rho > 0.7) was found. Despite its efficacy in migraine prevention, a single session of onabotulinumtoxinA was not able to affect patients' sleep quality or their psychological symptoms.
慢性偏头痛是一种负担沉重的疾病,而肉毒毒素 A 已被证明是一种有效的治疗方法。偏头痛与睡眠呈双向关系,但预防性治疗对睡眠质量的影响研究甚少。本研究旨在评估单次肉毒毒素 A 治疗对患者睡眠质量的影响,并将结果与共病焦虑/抑郁的测量结果相关联。患者完成了关于睡眠质量的自我管理问卷(匹兹堡睡眠质量指数-PSQI)和心理症状(贝克抑郁量表第 2 版-BDI-II-和医院焦虑和抑郁量表-HADS-子量表"a"和"d"分别用于焦虑和抑郁),并在基线和 12 周后报告偏头痛发作频率。42 名纳入患者的偏头痛发作天数显著减少(从 20.6 ± 6.0 天减少至 13.6 ± 6.2 天, < 0.001),而睡眠质量(PSQI 评分从 11.0 ± 5.0 分减少至 9.8 ± 4.6 分, = 0.277)或心理测量结果(BDI-II 从 16.7 ± 10.2 分减少至 15.7 ± 10.3 分, = 0.678;HADS-a 从 10.3 ± 4.8 分减少至 9.3 ± 5.5 分, = 0.492;HADS-d 从 7.2 ± 3.9 分减少至 7.1 ± 5.0 分, = 0.901)无变化。另一方面,PSQI、BDI-II、HADS-a 和 HADS-d 评分之间存在很强的相关性(<0.001,rho > 0.7)。尽管单次肉毒毒素 A 治疗在预防偏头痛方面有效,但它不能影响患者的睡眠质量或心理症状。