Gklinos Panagiotis, Evangelopoulos Maria-Eleftheria, Velonakis Georgios, Mitsikostas Dimos Dimitrios
First Neurology Department, Eginition University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Research Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, 11528 Athens, Greece.
J Clin Med. 2025 Apr 17;14(8):2778. doi: 10.3390/jcm14082778.
: Over the past few decades, there has been increased scientific interest in the prevalence of headache disorders among people with MS (pwMS). Although the latest data suggest an association between migraine and multiple sclerosis, studies have been providing inconsistent results largely due to methodological differences, including small sample sizes, lack of control groups, absence of structured headache diaries, and variability in diagnostic criteria. This study aims to address the question of whether pwMS have a higher prevalence of primary headache disorders than healthy controls (HCs) and whether MS is associated with an increased risk of headaches. : In this cross-sectional, case-control study, consecutive pwMS from Eginition University Hospital, Athens, Greece, along with matched HCs, were recruited. Both groups were assessed for headache disorders, over the past 3 months from the day of recruitment, using a semi-structured questionnaire and diagnosed according to the International Classification for Headache Disorders 3 (ICHD-3) criteria. A multivariable logistic regression model adjusted for age and sex evaluated the association between MS and headache disorders. : Ninety-six pwMS and ninety-six matched HCs met the inclusion criteria and were enrolled in the study. A higher prevalence of primary headache disorders in pwMS (71.9%) compared to HCs (43.8%) was observed. Specifically, 28.1% of pwMS had migraine, and 38.5% had tension-type headache (TTH). PwMS were significantly more likely to be diagnosed with any primary headache disorder (OR = 4.54; 95% CI: 2.28 to 9.04; = 1.7), migraine (OR = 2.21 95% CI: 1.05 to 4.62; < 0.05), and TTH (OR = 2.16 95% CI: 1.16 to 4; < 0.05) compared to HCs. : Our study suggests that primary headache disorders are more prevalent in pwMS in a cohort recruited from the MS outpatient clinic at Eginition University Hospital in Athens, Greece, compared to the general population and highlights the need for targeted headache management within this group. Prospective longitudinal studies are needed to draw more robust conclusions on a potential association and its underlying mechanisms.
在过去几十年中，科学界对多发性硬化症患者（pwMS）中头痛障碍的患病率越来越感兴趣。尽管最新数据表明偏头痛与多发性硬化症之间存在关联，但由于方法学上的差异，包括样本量小、缺乏对照组、没有结构化头痛日记以及诊断标准的变异性，研究结果一直不一致。本研究旨在解决以下问题：pwMS的原发性头痛障碍患病率是否高于健康对照组（HCs），以及多发性硬化症是否与头痛风险增加有关。
在这项横断面病例对照研究中，招募了来自希腊雅典埃吉尼翁大学医院的连续pwMS患者以及匹配的HCs。从招募之日起的过去3个月内，使用半结构化问卷对两组进行头痛障碍评估，并根据《国际头痛疾病分类第3版》（ICHD-3）标准进行诊断。采用调整了年龄和性别的多变量逻辑回归模型评估多发性硬化症与头痛障碍之间的关联。
96名pwMS患者和96名匹配的HCs符合纳入标准并被纳入研究。观察到pwMS中原发性头痛障碍的患病率（71.9%）高于HCs（43.8%）。具体而言，28.1%的pwMS患者患有偏头痛，38.5%患有紧张型头痛（TTH）。与HCs相比，pwMS被诊断为任何原发性头痛障碍（OR = 4.54；95% CI：2.28至9.04；P = 1.7）、偏头痛（OR = 2.21，95% CI：1.05至4.62；P < 0.05）和TTH（OR = 2.16，95% CI：1.16至4；P < 0.05）的可能性显著更高。
我们的研究表明，在从希腊雅典埃吉尼翁大学医院多发性硬化症门诊招募的队列中，与一般人群相比，pwMS中原发性头痛障碍更为普遍，并强调了该组内针对性头痛管理的必要性。需要进行前瞻性纵向研究，以就潜在关联及其潜在机制得出更可靠的结论。
