Associations Between Migraine and the Most Common Psychiatric Co‐Morbidities

Bergman-Bock, Stuart

doi:10.1111/head.13146

Cited by 36 publications

(33 citation statements)

References 52 publications

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“…While no CTh studies have been conducted to explore headache phase-related cortical plasticity in migraine. An extensive literature has shown that a wide range of psychiatric disorders, especially anxiety and depression, can accompany migraine [4,[47][48][49]. Previous studies revealed cortical abnormalities in depression [35,50,51] and anxiety disorders [52][53][54][55].…”

Section: Discussionmentioning

confidence: 99%

Cortical thickness in migraine: a coordinate-based meta-analysis

Sheng

Shi³

et al. 2020

Preprint

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Background Cortical thickness (CTh) analysis is a popular method to characterize brain morphometry. Many studies have been performed to investigate CTh abnormalities in migraine. However, the results from these studies were not consistent and even conflicting. These divergent results hinder us from obtaining a clear picture of brain morphometry regarding CTh alterations in migraine. Coordinate-based meta-analysis (CBMA) is a promising technique to quantitatively pool individual neuroimaging studies to identify consistent brain areas involved. Methods Electronic databases (PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang, and SinoMed) and other sources (bioRxiv and reference lists of relevant articles and reviews) were systematically searched for studies that compared regional CTh differences between patients with migraine and healthy controls (HCs) up to May 15, 2020. A CBMA was performed using the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) approach. Results In total, we identified 16 studies with 17 datasets reported that were eligible for the CBMA. The 17 datasets included 872 patients with migraine (average sample size 51.3, mean age 39.6 years, 721 females) and 949 HCs (average sample size 59.3, mean age 44.2 years, 680 females). The CBMA detected no statistically significant consistency of CTh alterations in patients with migraine relative to HCs. Sensitivity analysis and subgroup analysis verified this result to be robust. Meta-regression analyses revealed that this CBMA result was not confounded by age, gender, aura, attack frequency per month, and illness duration. Conclusions Our CBMA adds to the evidence of the replication crisis in neuroimaging research that is increasingly recognized. The current evidence suggests that CTh is not a reliable biomarker of migraine. Many potential confounders, such as underpowered sample size, heterogeneous patient selection criteria, and differences in imaging collection and methodology, may contribute to the inconsistencies of CTh alterations in migraine, which merit attention before planning future research on this topic.

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Section: Discussionmentioning

confidence: 99%

Cortical thickness in migraine: a coordinate-based meta-analysis

Sheng

Shi³

et al. 2020

Preprint

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“…73 Further study is needed of the behavioral and pharmacological insomnia therapies, but to date only the behavioral approach improved headache. Psychiatric Comorbidity.-Psychiatric disorders are comorbid with both headache 74,75 and sleep disorders. [76][77][78] Insomnia and/or daytime sleepiness are symptoms of mood and anxiety disorders as well as chemical dependencies.…”

Section: Assess Sleep Disturbance and Insomnia In Chronicmentioning

confidence: 99%

Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders

Rains

2018

Headache

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The relationship of sleep and migraine is unequivocal and familiarity with the nature and magnitude of these associations may inform clinical practice. Recent prospective, longitudinal, and time-series analysis has begun to unravel the magnitude and temporal patterns of sleep and migraine. Prospective evidence has shown that sleep variables can trigger acute migraine, precede and predict new onset headache by several years, and indeed, sleep disturbance and snoring are risk factors for chronification. The presence of a sleep disorder is associated with more frequent and severe migraine and portends a poorer headache prognosis. Interestingly, the disorders linked to migraine are quite varied, including insomnia, snoring and obstructive sleep apnea, restless legs, circadian rhythm disorders, narcolepsy, and others. Insomnia is by far the most common sleep disorder in headache patients. In fact, the majority of patients with chronic migraine presenting for treatment have insomnia. Despite a rapidly expanding literature, very few controlled treatment studies have been published to guide clinical practice. This paper focuses on clinical assessment and treatment of sleep disorders. An algorithm is presented for sleep disorders management in the migraine patient, which highlights major sleep disorders and psychiatric comorbidity. Diagnostic procedures are recommended that are conducive to clinical practice. Suggested tools include the sleep history, screening mnemonics, prediction equation, and sleep diary. New developments in treatment have produced abbreviated and cost-effective therapies for insomnia and obstructive sleep apnea that may reach a larger population. Revisions in the diagnostic manuals for sleep and headache disorders enhance recognition of sleep-related headache. Recommendations include behavioral sleep regulation, shown in recent controlled trials to decrease migraine frequency, management for sleep apnea headache, cognitive behavioral therapy (CBT) for insomnia abbreviated for the physician practice setting, sleep-related headache trigger, and others. There is no empirical evidence that sleep evaluation should delay or supersede usual headache care. Rather, sleep management is complimentary to standard headache practice.

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“…However, a direct comparison to previous work is quite difficult, since only a few recent studies investigated a variety of comorbidities . Thus, the most well‐known concomitant disease of patients suffering from migraine is the psychological/psychiatric disorder, which has been supported by a large body of evidence of clinical and population‐based studies . A representative US study conducted by Breslau and his colleagues showed a threefold higher lifetime prevalence of major depression in persons with migraine or severe headache, compared with the healthy control group .…”

Section: Discussionmentioning

confidence: 99%

“…35 Thus, the most well-known concomitant disease of patients suffering from migraine is the psychological/psychiatric disorder, which has been supported by a large body of evidence of clinical and population-based studies. 17,20,36,37 A representative US study conducted by Breslau and his colleagues showed a threefold higher lifetime prevalence of major depression in persons with migraine or severe headache, compared with the healthy control group. 38 Similar to our finding the authors estimated that about 41% of those patients with migraine were diagnosed with major depression.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][17] But, prior epidemiologic studies have primarily focused on one single condition, mostly psychiatric disorders including anxiety and depression, and thus only few recent work investigated a variety of comorbidities. 3,[17][18][19][20] Furthermore, previous research was based on carefully selected patient populations and there is only a small number of (inter-) national studies providing a current and comprehensive overview of comorbidities and treatment patterns in real-life patients and the associated healthcare costs of migraine. [21][22][23] Given the fact that the GCRP medications will strongly impact the available treatment options for patients with specific medical problems, the present study aims to analyse a huge variety of migraine comorbidities and its associated healthcare costs based on patients' real-life data from a large, population-based sample of health insurance enrollees in Switzerland.…”

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confidence: 99%

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Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

Huber

Agosti

Näpflin

et al. 2019

Pharmacoepidemiology and Drug

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Purpose In course of the new migraine drug development on the global market it is important to quantify the current burden of migraine medication. This study aimed to estimate the comorbidity burden and its relation to healthcare costs in patients using triptans in Switzerland by analyzing a large population‐based database. Methods This retrospective cohort study was based on Swiss health insurance claims data (2015/2016). The study sample comprised adult patients with ≥1 triptan prescription in 2015. We evaluated pharmaceutically treated comorbid conditions (CCs) and costs (12 months after index prescription) of patients using triptan. Multivariable linear regression models with log‐transformed outcomes were performed to identify the factors related to healthcare costs. Results From a total of 749 092, we identified 10,090 patients using triptans (1‐year prevalence of 1.35%), whereas 58.9% had ≥2 CCs. The most frequent CCs were pain‐ and rheumatologic‐related diseases and psychological disorders. Among triptan users, the mean total healthcare costs were highest in older patients with ≥2 CCs (>64 years: migraine with ≥2 CC “12 331 SFr”). Multivariate regression analyses showed that psychological disorders had the strongest impact on healthcare costs (Coefficient: 1.29; 95%‐CI: 1.27‐1.31). Conclusions The present study provides an overview of comorbidities and its related costs in migraine patients, which helps to quantify the current burden of migraine. This is relevant as the recently licensed CGRP antagonists are likely to change current treatment schemes for migraine, which strongly depends also on the comorbidities. The present study might therefore be helpful for the future development of treatment guidelines.

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Associations Between Migraine and the Most Common Psychiatric Co‐Morbidities

Cited by 36 publications

References 52 publications

Cortical thickness in migraine: a coordinate-based meta-analysis

Cortical thickness in migraine: a coordinate-based meta-analysis

Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders

Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

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