Predictability of Future Attacks by Migraineurs: A Prospective Observational Study

Hu, Xiaohan; Golden, Wendy L.; Bolge, S.; Katić, Božena; Chen, Ya-Ting; Wagner, Samuel; Cady, Roger

doi:10.1111/j.1526-4610.2010.01630.x

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…Migraine is a disorder with recurrent episodes of pain, being cyclic and unexpected. Negative expectations and anticipatory uncertainty about the timing and severity of a next pain episode are persistently reported during the in‐between attack period; as indicated previously, one would predict that such expectations may affect pain intensity in the upcoming attack. Anticipation to upcoming non‐painful experimental sensory events in migraineurs during the interictal state has been extensively investigated by neurophysiological tools providing strong evidence for the existence of enhanced sensory anticipation in these patients.…”

mentioning

confidence: 76%

Enhanced Pain Expectation in Migraine:EEG‐Based Evidence for Impaired Prefrontal Function

2012

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Our findings of impaired modulation of anticipated pain in migraine suggest a heightened state of anticipatory readiness combined with ineffective recruitment of prefrontal inhibitory pathways during experience of pain; the latter might account for the former, at least partially. In line, less efficient inhibitory capability is a plausible mechanistic explanation for patients' high concern about their upcoming migraine attacks.

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confidence: 76%

Enhanced Pain Expectation in Migraine:EEG‐Based Evidence for Impaired Prefrontal Function

2012

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“…7, 20 Migraineurs have interictal hypervigilance, watching out for symptoms of their next migraine attack and calculating the risk of exposing themselves to potential migraine triggers vs. avoiding those potential triggers. 8 In this study, migraineurs had greater pain-induced activation of several cognitive pain-processing regions including middle cingulate, fusiform gyrus, hippocampus, and premotor cortex.…”

Section: Discussionmentioning

confidence: 99%

Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine

et al. 2014

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Objective To identify brain regions having aberrant pain-induced activation in migraineurs, thereby gaining insight into particular aspects of pain processing that are atypical in migraineurs. Methods Functional magnetic resonance imaging assessed whole brain responses to painful heat in 24 adult episodic migraineurs who were at least 48 hours pain free and 27 healthy controls. Regions differentially activated in migraineurs compared to controls were identified. Activation intensities in these regions were correlated with headache frequency, number of migraine years, and time to next migraine attack. Results Migraineurs had greater pain-induced activation of lentiform nucleus, fusiform gyrus, subthalamic nucleus, hippocampus, middle cingulate cortex, premotor cortex, somatosensory cortex and dorsolateral prefrontal cortex, and less activation in precentral gyrus and superior temporal gyrus. There were significant correlations between activation strength and headache frequency for middle cingulate (r=0.627, p=.001), right dorsolateral prefrontal cortex (r=.568, p=.004), left fusiform gyrus (r=0.487, p=.016), left precentral gyrus (r=.415, p=.044), and left hippocampus (r=0.404, p=.050) and with number of migraine years for left fusiform gyrus (r=0.425, p=.038). There were no significant correlations between activation strength and time to next migraine attack. Conclusions The majority of regions with enhanced pain-induced activation in headache-free migraineurs participate in cognitive aspects of pain perception such as attending to pain and pain memory. Enhanced cognitive pain processing by migraineurs might reflect cerebral hypersensitivity related to high expectations and hypervigilance for pain.

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“…Originally designed as a screening instrument for people severely affected by headache, who might most benefit from medical care, and to provide an outcome measure for clinical practice [21–26], clinical trials [24, 27–31] and epidemiologic studies [10, 18, 32–39], it is a measure of behavioural response to impairment rather than of disability itself, producing scores expressing lost useful time. Like HRQoL measures, it is intended to aggregate the impact of illness on an individual over a period of time; unlike SF-36, it is disease specific, although applicable to headache rather than only to MIG [40].…”

Section: Discussionmentioning

confidence: 99%

Will (or can) people pay for headache care in a poor country?

et al. 2011

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We asked whether attempts to introduce headache services in poor countries would be futile on grounds of cost and unsustainability. Using data from a population-based survey in the Republic of Georgia, an exemplary poor country with limited health care, and against the background of headache-attributed burden, we report on willingness to pay (WTP) for effective headache treatment. Consecutive households were visited in areas of Tbilisi (urban) and Kakheti (rural), together representative of Georgian habitation. Biologically unrelated adults were interviewed by medical residents using a structured ICHD-II-based diagnostic questionnaire, the MIDAS questionnaire and SF-36. The bidding-game method was employed to assess WTP. Of 1,145 respondents, 50.0% had episodic headache (migraine and/or tension-type headache) and 7.6% had headache on ≥15 days/month, which was not further diagnosed. MIDAS scores were higher in people with headache on ≥15 days/month (mean 11.2) than in those with episodic headache (mean 7.0; P = 0.004). People with headache had worse scores in all SF-36 sub-scales than those without, but no differences were found between headache types. Almost all (93%) respondents with headache reported WTP averaging USD 8 per month for effective headache treatment. WTP did not correlate with headache type or frequency, or with MIDAS or SF-36 scores. Headache is common and headache-attributed burden is high in Georgia, with a profound impact on HRQoL. Even those less affected indicated WTP for effective treatment, if it were available, that would on average cover costs, which locally are low. Headache services in a poor country are potentially sustainable.

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Predictability of Future Attacks by Migraineurs: A Prospective Observational Study

Abstract: Migraine sufferers are generally unable to predict onset of the next migraine. Lack of predictability heightens the importance of education and preparedness for a migraine attack which may also reduce fear and anxiety between attacks.

Cited by 10 publications

References 20 publications

Enhanced Pain Expectation in Migraine:EEG‐Based Evidence for Impaired Prefrontal Function

Enhanced Pain Expectation in Migraine:EEG‐Based Evidence for Impaired Prefrontal Function

Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine

Will (or can) people pay for headache care in a poor country?

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