Department of Neurology and Headache Center, Japanese Red Cross Shizuoka Hospital, 8-2 Ohtemachi, Aoi-ku, Shizuoka, 420-0853, Shizuoka, Japan.
Sendai Headache and Neurology Clinic, Sendai, Miyagi, Japan.
Sci Rep. 2024 Sep 30;14(1):22611. doi: 10.1038/s41598-024-74253-3.
Migraine is a multifactorial brain disorder characterized by recurrent disabling headaches and their associated features. Several studies have suggested that these features are related to headache impact, pain intensity, and psychiatric conditions. However, differences in the relationship between each associated feature and headache impact, pain intensity, or psychiatric conditions remain unclear. This study aimed to assess the impact of migraine-associated features on headache impact, pain intensity, and psychiatric conditions in patients with migraine. In this two-centered study, patients with migraine without aura (MwoA) were enrolled to exclude those without headaches and avoid the influence of medication overuse, which is commonly associated with chronic migraine. We used multiple logistic regression to analyze the headache impact, pain intensity, and psychiatric conditions measured using the Headache Impact Test (HIT-6), Visual Analog Scale (VAS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Patients' likelihood of experiencing symptoms such as nausea, vomiting, photophobia, phonophobia, osmophobia, and allodynia were also recorded. A total of 1103 patients with MwoA were enrolled in this study, and 164 patients were excluded from the study because of missing data. Finally, 939 patients with MwoAs were included. On multiple logistic regression analyses, nausea (odd ratios [OR] 1.87, confidence interval [CI]: 1.37-2.54), vomiting (OR 1.57, CI: 1.11-2.23), photophobia (OR 1.67, CI: 1.18-2.35), and allodynia (OR 1.56, CI: 1.06-2.28) were independent positive predictors of higher HIT-6 scores, and nausea (OR 1.72, CI: 1.22-2.43), vomiting (OR 1.84, CI: 1.29-2.63), phonophobia (OR 1.58, CI: 1.10-2.25), photophobia (OR 1.49, CI: 1.07-2.08), and allodynia (OR 1.81, CI: 1.24-2.66) were independent positive predictors of higher VAS score. Nausea (OR 1.49, CI: 1.09-2.02), phonophobia (OR 2.00, CI: 1.42-2.82), and allodynia (OR 1.81, CI: 1.24-2.63) were independent positive predictors of GAD-7 score. Nausea (OR 1.66, CI: 1.21-2.28), phonophobia (OR 1.49, CI: 1.05-2.11), and allodynia (OR 1.68, CI: 1.16-2.45) were independent positive predictors and vomiting (OR 0.54, CI: 0.37-0.78) was an independent negative predictor of PHQ-9 score. Our results suggest that nausea, vomiting, photophobia, phonophobia, and osmophobia have distinct effects on headache impact, pain intensity, and psychiatric conditions. Understanding these differences can aid in the personalized management of patients with MwoA.
偏头痛是一种多因素的脑部疾病，其特征是反复发作的致残性头痛及其相关特征。几项研究表明，这些特征与头痛影响、疼痛强度和精神状况有关。然而，每种相关特征与头痛影响、疼痛强度或精神状况之间的关系仍存在差异。本研究旨在评估偏头痛相关特征对偏头痛患者头痛影响、疼痛强度和精神状况的影响。在这项双中心研究中，纳入了无先兆偏头痛（MwoA）患者，以排除那些没有头痛的患者，并避免药物过度使用的影响，因为药物过度使用通常与慢性偏头痛有关。我们使用多变量逻辑回归分析了使用头痛影响测试（HIT-6）、视觉模拟量表（VAS）、广泛性焦虑症 7 项量表（GAD-7）和患者健康问卷-9（PHQ-9）测量的头痛影响、疼痛强度和精神状况。还记录了患者出现恶心、呕吐、畏光、畏声、嗅觉过敏和感觉异常等症状的可能性。共有 1103 例 MwoA 患者入组本研究，其中 164 例因数据缺失被排除研究。最终，939 例 MwoA 患者被纳入研究。在多变量逻辑回归分析中，恶心（比值比 [OR] 1.87，置信区间 [CI]：1.37-2.54）、呕吐（OR 1.57，CI：1.11-2.23）、畏光（OR 1.67，CI：1.18-2.35）和感觉异常（OR 1.56，CI：1.06-2.28）是 HIT-6 评分较高的独立阳性预测因素，而恶心（OR 1.72，CI：1.22-2.43）、呕吐（OR 1.84，CI：1.29-2.63）、畏声（OR 1.58，CI：1.10-2.25）、畏光（OR 1.49，CI：1.07-2.08）和感觉异常（OR 1.81，CI：1.24-2.66）是 VAS 评分较高的独立阳性预测因素。恶心（OR 1.49，CI：1.09-2.02）、畏声（OR 2.00，CI：1.42-2.82）和感觉异常（OR 1.81，CI：1.24-2.63）是 GAD-7 评分较高的独立阳性预测因素。恶心（OR 1.66，CI：1.21-2.28）、畏声（OR 1.49，CI：1.05-2.11）和感觉异常（OR 1.68，CI：1.16-2.45）是 PHQ-9 评分较高的独立阳性预测因素，而呕吐（OR 0.54，CI：0.37-0.78）是 PHQ-9 评分较低的独立阴性预测因素。我们的研究结果表明，恶心、呕吐、畏光、畏声和嗅觉过敏对头痛影响、疼痛强度和精神状况有不同的影响。了解这些差异有助于对 MwoA 患者进行个性化管理。
