Maslova N N, Klimov D S, Nikitenkova V E, Malakhova J A, Rakov A M
Smolensk State Medical University, Russia, Smolensk.
Multidisciplinary Clinic "Line of health", Russia, Smolensk.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(6):70-73. doi: 10.17116/jnevro202412406170.
To study the features of the primary forms of headache in patients with a confirmed diagnosis of multiple sclerosis (MS).
A total of 110 patients with MS were examined in the outpatient appointment of a neurologist at the Department of Neurology and Neurosurgery of the «Smolensk State Medical University» in the period from April 1, 2023 to May 31, 2023. A group of 20 people with a diagnosis of primary headache (PH) was selected. At the same time, a control group of 20 people with a diagnosis of PH was selected on the basis of the Center for Industrial Medicine of the Federal State Medical Institution MSU No. 135, Desnogorsk. The analysis of complaints, anamnestic, laboratory data, neurological status and test results on specialized scales was carried out.
Migraine was the most frequent type of headache in MS patients (in a ratio of 5.6:1 compared to tension headache) and was observed in 17 (85%) MS patients. Tension headache was diagnosed only in 3 (15%) patients (=0.002). Headache was significantly more common in the remitting form of MS (=0.046). Age, total cholesterol level, EDSS level, type of MS disease-modifying therapy were not associated with the risk of developing headache. When comparing the population of patients with MS and PH with the control group on the anxiety and depression scale and the MoCA test, statistically significant differences were obtained (<0.05).
PH were diagnosed in 18.2% of patients with MS, with a much higher prevalence of migraines than tension headache. In addition, female gender and the type of MS are significantly associated with the risk of migraine. Migraine, as a comorbid condition, can aggravate cognitive impairment in patients with MS, characterized by a lower value of the MoCA scale, especially together with the progression of anxiety and depressive disorders. These findings indicate the need for a larger epidemiological study to accurately assess the prevalence of PH in patients with MS in the Smolensk region.
研究确诊为多发性硬化症（MS）患者原发性头痛的主要类型特征。
2023年4月1日至2023年5月31日期间，在“斯摩棱斯克国立医科大学”神经内外科神经科门诊对110例MS患者进行了检查。选取了一组20例诊断为原发性头痛（PH）的患者。同时，在德斯诺戈尔斯克第135号联邦国家医疗机构莫斯科国立大学工业医学中心的基础上，选取了另一组20例诊断为PH的患者作为对照组。对患者的主诉、既往史、实验室数据、神经学状态以及专业量表测试结果进行了分析。
偏头痛是MS患者中最常见的头痛类型（与紧张性头痛的比例为5.6:1），17例（85%）MS患者出现偏头痛。仅3例（15%）患者被诊断为紧张性头痛（P = 0.002）。头痛在MS缓解期更为常见（P = 0.046）。年龄、总胆固醇水平、扩展残疾状态量表（EDSS）水平、MS疾病修正治疗类型与头痛发生风险无关。在焦虑抑郁量表和蒙特利尔认知评估量表（MoCA）测试中，将MS和PH患者群体与对照组进行比较时，获得了具有统计学意义的差异（P < ）。
18.2%的MS患者被诊断为PH，偏头痛的患病率远高于紧张性头痛。此外，女性性别和MS类型与偏头痛风险显著相关。偏头痛作为一种合并症，可加重MS患者的认知障碍，其特征是MoCA量表得分较低，尤其是在焦虑和抑郁障碍进展时。这些发现表明需要进行更大规模的流行病学研究，以准确评估斯摩棱斯克地区MS患者中PH的患病率。
