The role of personality, disability and physical activity in the development of medication-overuse headache: a prospective observational study.

Autor: Mose LS; Department of Neurology, Hospital Southwest Jutland, Esbjerg, Denmark. Louise.schlosser@rsyd.dk.; The Research Unit of Health Science, Hospital of Southwest Jutland, Esbjerg and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark. Louise.schlosser@rsyd.dk., Pedersen SS; Department of Psychology, University of Southern Denmark, Odense, Denmark.; Department of Cardiology, Odense University Hospital, Odense, Denmark., Debrabant B; Epidemiology, Biostatistics and Biodemography Department of Public Health, University of Southern Denmark, Odense, Denmark., Jensen RH; Danish Headache Centre, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark., Gram B; The Research Unit of Health Science, Hospital of Southwest Jutland, Esbjerg and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2018 May 25; Vol. 19 (1), pp. 39. Date of Electronic Publication: 2018 May 25.
DOI: 10.1186/s10194-018-0863-1
Abstrakt: Background: Factors associated with development of medication-overuse headache (MOH) in migraine patients are not fully understood, but with respect to prevention, the ability to predict the onset of MOH is clinically important. The aims were to examine if personality characteristics, disability and physical activity level are associated with the onset of MOH in a group of migraine patients and explore to which extend these factors combined can predict the onset of MOH.
Methods: The study was a single-center prospective observational study of migraine patients. At inclusion, all patients completed questionnaires evaluating 1) personality (NEO Five-Factor Inventory), 2) disability (Migraine Disability Assessment), and 3) physical activity level (Physical Activity Scale 2.1). Diagnostic codes from patients' electronic health records confirmed if they had developed MOH during the study period of 20 months. Analyses of associations were performed and to identify which of the variables predict onset MOH, a multivariable least absolute shrinkage and selection operator (LASSO) logistic regression model was fitted to predict presence or absence of MOH.
Results: Out of 131 participants, 12 % (n=16) developed MOH. Migraine disability score (OR=1.02, 95 % CI: 1.00 to 1.04), intensity of headache (OR=1.49, 95 % CI: 1.03 to 2.15) and headache frequency (OR=1.02, 95 % CI: 1.00 to 1.04) were associated with the onset of MOH adjusting for age and gender. To identify which of the variables predict onset MOH, we used a LASSO regression model, and evaluating the predictive performance of the LASSO-mode (containing the predictors MIDAS score, MIDAS-intensity and -frequency, neuroticism score, time with moderate physical activity, educational level, hours of sleep daily and number of contacts to the headache clinic) in terms of area under the curve (AUC) was weak (apparent AUC=0.62, 95% CI: 0.41-0.82).
Conclusion: Disability, headache intensity and frequency were associated with the onset of MOH whereas personality and the level of physical activity were not. The multivariable LASSO model based on personality, disability and physical activity is applicable despite moderate study size, however it can be considered as a weak classifier for discriminating between absence and presence of MOH.
Databáze: MEDLINE
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