Resistant and refractory migraine - two different entities with different comorbidities? Results from the REFINE study.

Autor: Rosignoli C; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Ornello R; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Caponnetto V; Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy., Onofri A; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Avaltroni S; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy., Braschinsky M; Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia., Šved O; Department of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia., Gil-Gouveia R; Headache Center, Hospital da Luz, Lisbon, Portugal., Lampl C; Headache Medical Center, Seilerstaette Linz, Linz, Austria., Paungarttner J; Headache Medical Center, Seilerstaette Linz, Linz, Austria., Martelletti P; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Wells-Gatnik WD; Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy., Martins IP; Centro de Estudos Egas Moniz, Faculty of Medicine, University of Lisbon, Lisbon, Portugal., Mitsikostas D; First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece., Apostolakopoulou L; First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece., Nabaei G; Iranian Center of Neurological Research, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran., Ozge A; Department of Neurology, Mersin University Medical Faculty, Mersin, Turkey., Narin DB; Department of Neurology, Mersin University Medical Faculty, Mersin, Turkey., Pozo-Rosich P; Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Muñoz-Vendrell A; Headache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain., Prudenzano MP; Headache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy., Gentile M; Headache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy., Ryliskiene K; Center of Neurology, Vilnius University, Vilnius, Lithuania., Vainauskiene J; Center of Neurology, Vilnius University, Vilnius, Lithuania., Del Rio MS; Department of Neurology, Clínica Universidad de Navarra, Madrid, Spain., Vernieri F; Unit of Headache and Neurosonology, Fondazione Policlinico Campus Bio-Medico and Neurology, Università Campus Bio-Medico di Roma, Roma, Italy., Iaccarino G; Unit of Headache and Neurosonology, Fondazione Policlinico Campus Bio-Medico and Neurology, Università Campus Bio-Medico di Roma, Roma, Italy., Waliszewska-Prosol M; Department of Neurology, Wroclaw Medical University, Wrocław, Poland., Budrewicz S; Department of Neurology, Wroclaw Medical University, Wrocław, Poland., Carnovali M; Department of Neurology, Christian Hospital Unna and University of Duisburg-Essen, Ruhr Metropolitan, Germany., Katsarava Z; Department of Neurology, Christian Hospital Unna and University of Duisburg-Essen, Ruhr Metropolitan, Germany., Sacco S; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2024 Dec 03; Vol. 25 (1), pp. 212. Date of Electronic Publication: 2024 Dec 03.
DOI: 10.1186/s10194-024-01910-3
Abstrakt: Background: Resistant and refractory migraine are commonly encountered in specialized headache centers. Several comorbidities, mostly psychiatric conditions, have been linked to migraine worsening; however, there is little knowledge of the comorbidity profile of individuals with resistant and refractory migraine.
Methods: REFINE is a prospective observational multicenter international study involving individuals with migraine from 15 headache centers. Participants were categorized into three groups based on the European Headache Federation criteria: non-resistant and non-refractory (NRNRM), resistant (ResM), and refractory (RefM). We explored the prevalence of 20 comorbidities at baseline in the three groups.
Results: Of the 689 included patients (82.8% women), 262 (38.0%) had ResM, 73 (10.4%) had RefM and 354 (51.4%) NRNRM. A higher prevalence of psychiatric comorbidities, trigger points, temporomandibular joint disorders, thyroiditis, and cerebrovascular diseases was observed in the RefM group, followed by ResM and NRNRM. Multiple comorbidities were more common in the RefM group, followed by the ResM group and by the NRNRM group (41.6% vs. 24.5% vs. 14.1% respectively; p < 0.001). At the sensitivity analysis, exploring participants with chronic migraine, significant differences among the NRNRM, ResM, and RefM groups were found in the prevalence of anxiety (p < 0.001), asthma and rhinitis (p = 0.013), bipolar and other psychiatric disorders (p = 0.049), cerebrovascular diseases (p < 0.001), depression (p < 0.001), obesity (p = 0.002), thyroiditis (p < 0.001), and trigger points (p = 0.008).
Conclusion: REFINE data indicate that individuals with ResM and RefM have a higher burden of comorbidities than those with NRNRM. It can be postulated that those comorbidities may have an impact on the progression of migraine from a form that is easy to treat to a form that is resistant or refractory to treatments. Longitudinal studies are needed to understand the direction of the association between ResM or RefM and those comorbidities and if proper treatment of comorbidities might help overcome treatment resistance or refractoriness.
Competing Interests: Declarations. Competing interests: P.M. serves as the Editor-in-Chief of The Journal of Headache and Pain.
(© 2024. The Author(s).)
Databáze: MEDLINE
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