Lampl Christian, Seng Elizabeth, Vincent Maurice, Lenderking William R, Hoyt Margaret, Hetherington Lucinda, Ladd Mary Kate, Malley Karen, Chen Jun, Viktrup Lars
Department of Neurology, Konventhospital Barmherzige Brüder Linz, Linz, Austria.
Albert Einstein College of Medicine, Bronx, NY, USA.
J Headache Pain. 2024 Dec 18;25(1):220. doi: 10.1186/s10194-024-01927-8.
The total burden of migraine includes not only the episodes with headache pain but extends throughout the interictal periods. Interictal symptoms and associated psychological responses may profoundly impact well-being and drive treatment-seeking behavior.
A cross-sectional online survey was conducted with participants aged ≥ 18 years, 250 with episodic migraine (EM) and 250 with chronic migraine (CM), having ≥ 4 monthly migraine headache days. All were naïve to galcanezumab or began ≤ 6 months before survey completion. The study evaluated factors associated with the Migraine Interictal Burden Scale (MIBS-4), including social determinants of health and well-being. Multiple linear regression, logistic regression, and random forests (RF) were used to explore predictors of MIBS-4.
The majority of participants (90%) were female with a mean (standard deviation) age of 40.6 (± 12.0) years and 18.1 (± 12.7) years since the first migraine episode. Sociodemographically, the EM and CM groups were similar. Common comorbidities were anxiety disorder (45%) and depression (44%). Migraine family history was reported in 59% of participants. MIBS-4 was correlated with a number of diverse variables, including well-being, anxiety sensitivity, income, aura symptoms, and the worst migraine pain in the year before starting galcanezumab. Linear and logistic regression identified years since the first symptom, worst migraine attack pain, premonitory symptoms, and income as significant predictors. RF explained more of the variance than multiple linear regression and introduced additional concepts to the prediction of MIBS, identifying well-being (WHO-5 total score), the WHO-5 item "cheerful and in good spirits," worry about exercise, and fear of missing social obligations as significant predictors. Socioeconomic status and income were also critical explanatory variables for interictal burden (IIB) based on regression modeling and RF. Still, income was the only variable significantly associated with IIB across regression and RF methods.
Interictal burden should be considered in the medical care of people with migraine. This additional burden is holistic, with psychosocial and socioeconomic elements in addition to residual symptoms. It is essential to consider this when assessing the impact of IIB.
偏头痛的总体负担不仅包括头痛发作期，还贯穿于发作间期。发作间期症状及相关心理反应可能会对健康产生深远影响，并促使患者寻求治疗。
对年龄≥18岁的参与者进行了一项横断面在线调查，其中250例为发作性偏头痛（EM）患者，250例为慢性偏头痛（CM）患者，每月偏头痛头痛天数≥4天。所有参与者均未使用过加卡尼单抗，或在调查完成前≤6个月开始使用。该研究评估了与偏头痛发作间期负担量表（MIBS-4）相关的因素，包括健康和幸福的社会决定因素。使用多元线性回归、逻辑回归和随机森林（RF）来探索MIBS-4的预测因素。
大多数参与者（90%）为女性，平均（标准差）年龄为40.6（±12.0）岁，自首次偏头痛发作以来已有18.1（±12.7）年。在社会人口统计学方面，EM组和CM组相似。常见的合并症为焦虑症（45%）和抑郁症（44%）。59%的参与者报告有偏头痛家族史。MIBS-4与许多不同变量相关，包括幸福感、焦虑敏感性、收入、先兆症状以及开始使用加卡尼单抗前一年中最严重的偏头痛疼痛。线性和逻辑回归确定自首次出现症状以来的年数、最严重的偏头痛发作疼痛、先兆症状和收入为显著预测因素。RF比多元线性回归解释了更多的方差，并为MIBS的预测引入了其他概念，确定幸福感（WHO-5总分）、WHO-5项目“愉快且精神良好”、对运动的担忧以及对错过社交义务的恐惧为显著预测因素。基于回归模型和RF，社会经济地位和收入也是发作间期负担（IIB）的关键解释变量。然而，在回归和RF方法中，收入是唯一与IIB显著相关的变量。
在偏头痛患者的医疗护理中应考虑发作间期负担。这种额外的负担是整体性的，除了残留症状外，还包括心理社会和社会经济因素。在评估IIB的影响时考虑到这一点至关重要。
