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1.
Acta Neurol Scand ; 145(1): 87-93, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34523724

RESUMO

OBJECTIVES: The association between migraine and dementia has rarely been investigated, and available results are conflicting. Thus, the aim of this meta-analysis was to evaluate whether an association exists between migraine and dementia. MATERIALS & METHODS: We searched for cohort studies from databases including PubMed, EBSCO, Web of Science, and EMBASE database from inception to April 1, 2021, using subject and free words. RevMan 5.1 software was used to calculate the risk ratio (RR) of dementia in patients with migraine. Subgroup and sensitivity analyses were conducted to assess the source of heterogeneity. A random-effects model was used when heterogeneity was present. The Funnel plot and Egger's test were used to evaluate publication bias. RESULTS: Five published cohort studies covering a total of 249,303 individuals were identified. Pooled analysis showed that migraine was associated with increased risk of all-cause dementia (RR: 1.34, 95% CI: 1.13-1.59) and Alzheimer's disease (AD) (RR: 2.49, 95% CI: 1.16-5.32). However, we did not found any association between migraine and risk of vascular dementia (VaD) (RR: 1.51, 95% CI: 0.77-2.96). CONCLUSIONS: Our results revealed that migraine was a potential risk indicator for AD and all-cause dementia.


Assuntos
Doença de Alzheimer , Demência , Transtornos de Enxaqueca , Estudos de Coortes , Demência/epidemiologia , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/epidemiologia , Fatores de Risco
2.
PLoS One ; 16(12): e0261570, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34929017

RESUMO

Previous studies targeting inter-individual differences in pain processing in migraine mainly focused on the perception of pain. Our main aim was to disentangle pain anticipation and perception using a classical fear conditioning task, and investigate how migraine frequency and pre-scan cortisol-to-dehydroepiandrosterone sulfate (DHEA-S) ratio as an index of neurobiological stress response would relate to neural activation in these two phases. Functional Magnetic Resonance Imaging (fMRI) data of 23 participants (18 females; mean age: 27.61± 5.36) with episodic migraine without aura were analysed. We found that migraine frequency was significantly associated with pain anticipation in brain regions comprising the midcingulate and caudate, whereas pre-scan cortisol-to DHEA-S ratio was related to pain perception in the pre-supplementary motor area (pre-SMA). Both results suggest exaggerated preparatory responses to pain or more general to stressors, which may contribute to the allostatic load caused by stressors and migraine attacks on the brain.


Assuntos
Sulfato de Desidroepiandrosterona/metabolismo , Hidrocortisona/metabolismo , Transtornos de Enxaqueca/psicologia , Percepção da Dor , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Química Encefálica , Sulfato de Desidroepiandrosterona/análise , Feminino , Neuroimagem Funcional , Humanos , Hidrocortisona/análise , Individualidade , Imageamento por Ressonância Magnética , Masculino , Transtornos de Enxaqueca/epidemiologia , Adulto Jovem
3.
Curr Pain Headache Rep ; 25(12): 82, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34910265

RESUMO

PURPOSE OF REVIEW: This review aims to discuss the experience of migraine in transgender and gender-diverse individuals as it relates to other psychiatric comorbidities such as anxiety, depression, PTSD, and others. As this population faces stigma and discrimination, literature posits that gender minority stress can also contribute to the experience of pain in these individuals. RECENT FINDINGS: Though there is little explicit data on these topics, more recent studies have explored the concept of gender minority stress and how stigma and discrimination can affect health outcomes and overall perception of health. These findings, as well as data on psychiatric comorbidities in cisgender individuals with migraine, can be extrapolated to understand how gender minority individuals may experience migraine. Research has demonstrated that stigma and discrimination can affect health outcomes in the transgender and gender-diverse community. A recent study has shown that sexual minority stress associated with stigma, discrimination, and barriers to care can exacerbate migraine. It is known that psychiatric comorbidities such as anxiety, depression, and PTSD can affect migraine frequency and severity in cisgender individuals. Though there are no specific studies in the transgender and gender-diverse patient population, these highly prevalent mental health conditions could potentially contribute to their migraine experience. Hormones, as well, may affect mood in those on gender-affirming hormone therapy, with some studies exploring how this may have both a direct and indirect relationship with migraine. There are clear knowledge gaps that can be addressed by future research in these areas to better understand the migraine experience in transgender and gender-diverse individuals and improve overall care.


Assuntos
Transtornos Mentais , Transtornos de Enxaqueca , Minorias Sexuais e de Gênero , Pessoas Transgênero , Humanos , Transtornos de Enxaqueca/epidemiologia , Estigma Social
4.
J Headache Pain ; 22(1): 153, 2021 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-34922442

RESUMO

BACKGROUND: Headache disorders are disabling, with major consequences for productivity, yet the literature is silent on the relationship between headache-attributed disability and lost productivity, often erroneously regarding the two as synonymous. We evaluated the relationship empirically, having earlier found that investment in structured headache services would be cost saving, not merely cost-effective, if reductions in headache-attributed disability led to > 20% pro rata recovery of lost productivity. METHODS: We used individual participant data from Global Campaign population-based studies conducted in China, Ethiopia, India, Nepal, Pakistan and Russia, and from Eurolight in Lithuania, Luxembourg and Spain. We assessed relationships in migraine and probable medication-overuse headache (pMOH), the most disabling common headache disorders. Available symptom data included headache frequency, usual duration and usual intensity. We used frequency and duration to estimate proportion of time in ictal state (pTIS). Disability, in the sense used by the Global Burden of Disease study, was measured as the product of pTIS and disability weight for the ictal state. Impairment was measured as pTIS * intensity. Lost productivity was measured as lost days (absence or < 50% productivity) from paid work and corresponding losses from household work over the preceding 3 months. We used Spearman correlation and linear regression analyses. RESULTS: For migraine, in a linear model, we found positive associations with lost paid worktime, significant (p < 0.05) in many countries and highly significant (p < 0.001) in some despite low values of R2 (0-0.16) due to high variance. With lost household worktime and total lost productivity (paid + household), associations were highly significant in almost all countries, although still with low R2 (0.04-0.22). Applying the regression equations for each country to the population mean migraine-attributed disability, we found pro rata recoveries of lost productivity in the range 16-56% (> 20% in all countries but Pakistan). Analysing impairment rather than disability increased variability. For pMOH, with smaller numbers, associations were generally weaker, occasionally negative and mostly not significant. CONCLUSION: Relief of disability through effective treatment of migraine is expected, in most countries, to recover > 20% pro rata of lost productivity, above the threshold for investment in structured headache services to be cost saving.


Assuntos
Transtornos da Cefaleia Secundários , Transtornos de Enxaqueca , China , Cefaleia/epidemiologia , Humanos , Transtornos de Enxaqueca/epidemiologia , Nepal
5.
J Headache Pain ; 22(1): 155, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34930118

RESUMO

BACKGROUND: The purpose of this narrative review is to examine the literature investigating a causal relationship between stress and migraine and evaluate its implications for managing migraine. METHODS: PubMed, PsycINFO and CINAHL were searched from 1988 to August 2021, identifying 2223 records evaluating the relationship between stress and migraine. Records were systematically screened. All potentially relevant records were thematically categorized into six mechanistic groups. Within each group the most recent reports providing new insights were cited. RESULTS: First, studies have demonstrated an association of uncertain causality between high stress loads from stressful life events, daily hassles or other sources, and the incidence of new-onset migraine. Second, major stressful life events seem to precede the transformation from episodic to chronic migraine. Third, there is some evidence for changes in levels of stress as a risk factor for migraine attacks. Research also suggests there may be a reversed causality or that stress-trigger patterns are too individually heterogeneous for any generalized causality. Fourth, migraine symptom burden seems to increase in a setting of stress, partially driven by psychiatric comorbidity. Fifth, stress may induce sensitization and altered cortical excitability, partially explaining attack triggering, development of chronic migraine, and increased symptom burden including interictal symptom burden such as allodynia, photophobia or anxiety. Finally, behavioral interventions and forecasting models including stress variables seem to be useful in managing migraine. CONCLUSION: The exact causal relationships in which stress causes incidence, chronification, migraine attacks, or increased burden of migraine remains unclear. Several individuals benefit from stress-oriented therapies, and such therapies should be offered as an adjuvant to conventional treatment and to those with a preference. Further understanding the relationship between stress, migraine and effective therapeutic options is likely to be improved by characterizing individual patterns of stress and migraine, and may in turn improve therapeutics.


Assuntos
Transtornos de Enxaqueca , Terapia Comportamental , Humanos , Hiperalgesia , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/terapia , Fatores de Risco
6.
BMC Neurol ; 21(1): 493, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34930166

RESUMO

BACKGROUND: Cranial autonomic symptoms are common in migraine, with eye redness and tearing being the most common ones. Their identification can help to avoid misdiagnosis, predict the disease course, and select the appropriate treatment. METHODS: This was a cross-sectional study of 904 patients who presented with migraine to a headache referral clinic. The participants filled out a questionnaire about their headache characteristics, as well as the presence of cranial autonomic symptoms. A total of 904 patients, 698 women (77.2%) and 206 men (22.8%), were included in the study, with a mean (SD) age of 38.05 (11.76) years. RESULTS: About 70% of subjects with chronic migraine and 56.2% of those with episodic migraine reported one or more cranial autonomic symptoms. The two most commonly reported autonomic symptoms were eye redness (36.06%) and tearing (21.02%). Chronic migraine (43.4% vs. 29.5%), unilateral headache (56.8% vs. 48.7%), and blurred vision (20% vs. 14.7%) were significantly more frequent in migraineurs with cranial autonomic symptoms. Headache intensity and frequency in subjects with cranial autonomic symptoms were significantly higher than in those without cranial autonomic symptoms. CONCLUSION: We found higher percentages of cranial autonomic symptoms in patients with unilateral headaches, frequent and severe attacks and blurred vision. A diagnosis of cranial autonomic symptoms accompanying migraine may predict more severe disease and the possibility of evolution into chronic migraine.


Assuntos
Transtornos de Enxaqueca , Adulto , Estudos Transversais , Progressão da Doença , Feminino , Cefaleia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34769668

RESUMO

Migraine is a common neurological disorder considered the second most disabling condition worldwide. Its prevalence ranges from 2.6% to 21.7% in population studies. This study aimed to know the prevalence of diagnosed and undiagnosed migraine in the general Spanish adult population, their health care use, and factors related. A descriptive cross-sectional study was undertaken with 23,089 individuals >15 years from the 2017 Spanish National Health Survey. Three groups were defined: people diagnosed with migraine (DM), people reporting undiagnosed migraine (UM) and people without migraine. Sociodemographic, clinical and use of health resources data were collected. The scales Duke Social Support Index (DSSI) and General Health Questionnaire (GHQ-12) were used. Prevalence of DM and UM were determined with 95% confidence intervals. To determine the factors associated with DM and UM, a multinomial logistic regression model was used. The prevalence of DM was 8.6% (95%CI: 8.2-9), and UM, 0.9% (95%CI: 0.8-1). People with DM more frequently visited healthcare professionals (47.8%), required more supplementary tests (86.8), had a higher percentage of hospitalization (11.3%), and used emergency services (45.1%). Women had nearly three times the risk of DM and UM. Worse mental health was a risk factor for UM (OR = 1.20) and DM (OR = 1.18). The greater the work stress, the greater the risk of DM (OR = 1.12). An adequate monitoring and management of migraine in people with these characteristics could contribute to improving their quality of life and reducing costs in the system.


Assuntos
Recursos em Saúde , Transtornos de Enxaqueca , Adulto , Estudos Transversais , Feminino , Humanos , Transtornos de Enxaqueca/epidemiologia , Prevalência , Qualidade de Vida
8.
J Headache Pain ; 22(1): 140, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34800970

RESUMO

BACKGROUND: Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. METHODS: Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. RESULTS: Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. CONCLUSION: 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system.


Assuntos
Custos de Cuidados de Saúde , Transtornos de Enxaqueca , Adulto , Criança , Grupos Controle , Alemanha/epidemiologia , Cefaleia , Humanos , Seguro Saúde , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia
9.
BMC Neurol ; 21(1): 443, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758771

RESUMO

BACKGROUND: The prevalence of migraine headaches varied from 2.4 to 48.5% worldwide among university students. As per the knowledge of the investigators, the study of migraine headaches is not done in this study area. Hence, this study aimed to assess determinates of migraine headaches among regular undergraduate students, of Wollo University, Dessie, Ethiopia, 2020. METHOD: Institution-based cross-sectional study design was conducted from November 15-30 /2020 by using a self-administered questionnaire among 371 regular undergraduate students at Wollo University. A multistage sampling technique was employed to represent our study population. Identity migraine test, Migraine Disability Assessment Questionnaire, perceived stress scale, and Oslo social support scale was used. Descriptive statistics, binary and multiple logistic regression were employed. The adjusted odds ratio at a 95% confidence interval and level of significance (p-value < 0.05) was used to interpret the findings. RESULTS: From 371 participants, the prevalence of migraine headache in this study was 34% (95% CI: 29.2, 38.5). Variables statistically associated with migraine headache, were a family history of headache (AOR = 3.83, CI: 2.313, 6.366), suicidal thoughts in the past 3 months (AOR = 10.76, CI: 2.117, 54.74), and had low perceived stress 62.6% (AOR = 0.374, CI: 0.205, 0.683). CONCLUSION: In this study, the prevalence of migraine headaches was very high. Family history of headache, suicidal thoughts, and low perceived stress were determinates for migraine headache. So special emphasis shall be given to those participants who had high perceived stress, a family history of migraine headache, and suicidal thoughts.


Assuntos
Transtornos de Enxaqueca , Universidades , Estudos Transversais , Etiópia/epidemiologia , Humanos , Transtornos de Enxaqueca/epidemiologia , Prevalência , Estudantes , Inquéritos e Questionários
10.
J Pak Med Assoc ; 71(11): 2617-2622, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783746

RESUMO

Migraine is a type of headache associated with causing disability. It is considered the third main cause of disability among individuals aged <50 years. Environment around us does play an essential role in triggering the symptoms of migraine. The painful episodes can be prevented by adopting certain lifestyle changes, affecting the daily life activities of students. In the current narrative review, literature was searched on Google, Google Scholar and PubMed databases from 2015 to 2020. Migraine pain was found to be prevalent at different severity levels among college and university students, being more common in the females compared to the males. Identifying triggers is an essential feature in identifying and thus preventing the severity of migraine. As the disease affects the quality of life of students, it is essential to create more awareness so that students may approach physicians and maintain undisturbed focus on their academics.


Assuntos
Transtornos de Enxaqueca , Universidades , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/epidemiologia , Prevalência , Qualidade de Vida , Estudantes
11.
Eur Rev Med Pharmacol Sci ; 25(18): 5836-5842, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34604975

RESUMO

OBJECTIVE: Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents. PATIENTS AND METHODS: The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version.  The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease. RESULTS: The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome. CONCLUSIONS: Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.


Assuntos
COVID-19/psicologia , Gastroenteropatias/etiologia , Gastroenteropatias/psicologia , Quarentena/psicologia , Isolamento Social/psicologia , Estresse Psicológico/complicações , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Dor Abdominal/psicologia , Adolescente , Aerofagia/epidemiologia , Aerofagia/etiologia , Aerofagia/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Constipação Intestinal/psicologia , Dispepsia/epidemiologia , Dispepsia/etiologia , Dispepsia/psicologia , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Incontinência Fecal/psicologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/etiologia , Síndrome do Intestino Irritável/psicologia , Itália , Masculino , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/psicologia , Prevalência , Síndrome da Ruminação/epidemiologia , Síndrome da Ruminação/etiologia , Síndrome da Ruminação/psicologia , Estresse Psicológico/diagnóstico , Inquéritos e Questionários , Vômito/epidemiologia , Vômito/etiologia , Vômito/psicologia
12.
J Headache Pain ; 22(1): 119, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620097

RESUMO

BACKGROUND: Migraine is a common neurological disease with extremely debilitating, but fully reversible symptoms. Women suffer from migraine more often than men. It was assumed that fluctuation of oestrogen level during menstrual cycle is one of many factors responsible for more frequent migraine attacks. The second-to-fourth digit ratio (2D:4D) is considered as an indicator of prenatal sex steroids. Balance of prenatal androgens (testosterone) and oestrogen has been studied in numerous diseases that are affected by hormones. However, the relationship between migraine and the sex steroids balance in prenatal development is still unexplained. The aim of this paper is to provide an evidence of relationship between prenatal oestrogen and testosterone exposure following 2D:4D digit ratio, and migraine prevalence in adults. METHODS: We examined a group of 151 adults (33 males, 118 females) with migraine and a control group of 111 adults (45 males, 66 females). 2D:4D digit ratio of both hands was measured using sliding Vernier calliper. RESULTS: Significant differences were found in the right hand. Female migraineurs had lower value of 2D:4D ratio than the control group and the right 2D:4D was lower than left 2D:4D (Δ2D:4D), suggesting prenatal testosterone dominance. The opposite relationship was observed in males. Male migraineurs had higher value of 2D:4D ratio and Δ2D:4D was greater than the control group, suggesting prenatal oestrogen dominance. CONCLUSIONS: Our results suggest that depending on sex, different proportion of prenatal sex steroids might be a risk factor of migraine in adults. Women with migraine were presumably exposed in prenatal life to higher testosterone levels relative to oestrogen, while men with migraine were probably exposed in prenatal life to higher levels of oestrogen relative to testosterone.


Assuntos
Transtornos de Enxaqueca , Testosterona , Adulto , Estrogênios , Feminino , Hormônios Esteroides Gonadais , Humanos , Masculino , Transtornos de Enxaqueca/epidemiologia , Fatores de Risco
13.
Saudi Med J ; 42(10): 1103-1108, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34611005

RESUMO

OBJECTIVES: To estimate the prevalence of migraine headaches, assess the quality of life (QoL) of migraine patients, and compare the QoL between migraine patients and the general population in Jeddah, Kingdom of Saudi Arabia. METHODS: A descriptive cross-sectional study was carried out in 2021 on 2058 adults who agreed to participate in the study and completed a questionnaire. The ID-migraine scale was used to screen for migraine, and participants were divided into 3 groups (normal, non-migraine headaches, and migraine headache). To assess and compare the QoL between the migraine group and the normal population, the 36-item short- form survey was used. RESULTS: The prevalence of migraine headaches was 37.2%, with a higher prevalence among females (81.1%), and the highest prevalence was observed among students (43.3%). The most common manifestation associated with migraine headaches was photophobia (94.6%), and the most frequently reported triggers were sleep deprivation, stress, and anxiety. In our analysis of the association between migraine headaches and patient QoL, migraine patients showed lower scores in all 8 domains of QoL in comparison with the normal group. Role limitation due to physical health was the most affected domain. CONCLUSION: The current study showed a high prevalence of migraine in Jeddah. Insufficient sleep was the most frequently reported trigger. Migraine significantly affects all aspects of QoL in comparison with the normal population.


Assuntos
Transtornos de Enxaqueca , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Humanos , Transtornos de Enxaqueca/epidemiologia , Prevalência , Arábia Saudita/epidemiologia
14.
J Med Life ; 14(4): 498-503, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34621373

RESUMO

In this study, we aimed to find a correlation between anxiety related to dental procedures and migraines. A cross-sectional study was performed on 171 patients who attended specific dental clinics. The patients were randomly categorized into a migraine group (83) and a control group. To determine the anxiety level, all the patients filled out a validated questionnaire (the Arabic version of the Modified Dental Anxiety Scale). All responses ranged from "not anxious" (scoring 1) to "extremely anxious" (scoring 5). Based on the patient responses, the total score was recorded and compared statistically between the two groups. The sound of drilling was one of the most vital factors causing anxiety and headaches in migraine patients. Comparing the presence or absence of headache and usage of analgesics between the two groups, migraine patients complained to have headaches during or after dental treatment more frequently than controls and used analgesics more than non-migraine controls. Migraine patients visiting dental clinics feel more anxious about the working environment and need certain modifications before, during, and after dental procedures.


Assuntos
Ansiedade ao Tratamento Odontológico , Transtornos de Enxaqueca , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos de Ansiedade , Estudos Transversais , Ansiedade ao Tratamento Odontológico/epidemiologia , Cefaleia , Humanos , Transtornos de Enxaqueca/epidemiologia
15.
J Headache Pain ; 22(1): 124, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34645382

RESUMO

BACKGROUND: Migraine has been associated with cardiovascular disease (CVD) events among middle-aged adults. The objective of this study was to determine the risk for ischemic stroke and coronary heart disease (CHD) events among older adults with versus without migraine. METHODS: This retrospective cohort study was conducted using data from US adults ≥66 years of age with Medicare health insurance between 2008 and 2017. After stratification by history of CVD, patients with a history of migraine were matched 1:4 to those without a history of migraine, based on calendar year, age, and sex. Patients were followed through December 31, 2017 for ischemic stroke and CHD events including myocardial infarction or coronary revascularization. All analyses were done separately for patients with and without a history of CVD. RESULTS: Among patients without a history of CVD (n = 109,950 including n = 21,990 with migraine and n = 87,960 without migraine), 1789 had an ischemic stroke and 3552 had a CHD event. The adjusted hazard ratio (HR) among patients with versus without migraine was 1.20 (95% confidence interval [95%CI], 1.07-1.35) for ischemic stroke and 1.02 (95%CI, 0.93-1.11) for CHD events. Compared to patients without migraine, those with migraine who were taking an opioid medication had a higher risk for ischemic stroke (adjusted HR 1.43 [95%CI, 1.20-1.69]), while those taking a triptan had a lower risk for CHD events (adjusted HR 0.79 [95%CI, 0.67-0.93]). Among patients with a history of CVD (n = 79,515 including n = 15,903 with migraine and n = 63,612 without migraine), 2960 had an ischemic stroke and 7981 had a CHD event. The adjusted HRs (95%CI) for ischemic stroke and CHD events associated with migraine were 1.27 (1.17-1.39) and 0.99 (0.93-1.05), respectively. Patients with migraine taking an opioid medication had a higher risk for ischemic stroke (adjusted HR 1.21 [95%CI, 1.07-1.36]), while those taking a triptan had a lower risk for CHD events (adjusted HR 0.83 [95%CI, 0.72-0.95]), each versus those without migraine. CONCLUSIONS: Older adults with migraine are at increased risk for ischemic stroke. The risk for ischemic stroke among older adults with migraine may differ by migraine medication classes.


Assuntos
Isquemia Encefálica , Doenças Cardiovasculares , Doença das Coronárias , AVC Isquêmico , Transtornos de Enxaqueca , Acidente Vascular Cerebral , Idoso , Isquemia Encefálica/epidemiologia , Doença das Coronárias/epidemiologia , Humanos , Medicare , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Estados Unidos
16.
J Headache Pain ; 22(1): 123, 2021 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-34629054

RESUMO

BACKGROUND: Obesity confers adverse effects to every system in the body including the central nervous system. Obesity is associated with both migraine and idiopathic intracranial hypertension (IIH). The mechanisms underlying the association between obesity and these headache diseases remain unclear. METHODS: We conducted a narrative review of the evidence in both humans and rodents, for the putative mechanisms underlying the link between obesity, migraine and IIH. RESULTS: Truncal adiposity, a key feature of obesity, is associated with increased migraine morbidity and disability through increased headache severity, frequency and more severe cutaneous allodynia. Obesity may also increase intracranial pressure and could contribute to headache morbidity in migraine and be causative in IIH headache. Weight loss can improve both migraine and IIH headache. Preclinical research highlights that obesity increases the sensitivity of the trigeminovascular system to noxious stimuli including inflammatory stimuli, but the underlying molecular mechanisms remain unelucidated. CONCLUSIONS: This review highlights that at the epidemiological and clinical level, obesity increases morbidity in migraine and IIH headache, where weight loss can improve headache morbidity. However, further research is required to understand the molecular underpinnings of obesity related headache in order to generate novel treatments.


Assuntos
Transtornos de Enxaqueca , Pseudotumor Cerebral , Cefaleia , Humanos , Pressão Intracraniana , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Pseudotumor Cerebral/complicações , Pseudotumor Cerebral/epidemiologia
17.
J Affect Disord ; 295: 1229-1233, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34706437

RESUMO

BACKGROUND: This study aimed to examine the relationship between migraine and anxiety in US midlife women. METHODS: This study was conducted on the baseline data from the Study of Women's Health Across the Nation (SWAN), a multi-site longitudinal population-based study of the US midlife women. Logistic regression was performed to assess the odds ratios (ORs) and 95% confidence intervals (CIs) between migraine and anxiety, adjusting for the main potential confounders. RESULTS: A total of 3,302 midlife women aged from 42 to 52 with complete assessment of migraine and anxiety were enrolled. In both the crude model (OR: 1.47, 95% CI: 1.19-1.82, p < 0.001) and model 1 (OR: 1.31, 95% CI: 1.04-1.64, p = 0.022) indicated that anxiety was positive associated with migraine. After adjustment for age, ethnicity, family income, body mass index (BMI), smoking, alcohol drinking, physical activity, hypertension, diabetes, hypercholesterolemia, menopausal status, estradiol, dehydroepiandrosterone sulfate, follicle-stimulating hormone, sex hormone-binding globulin, testosterone, and thyroid stimulating hormone in full adjusted model 2, the association between migraine and anxiety remained statistically significant (OR: 1.28, 95% CI: 1.01-1.61, p = 0.038). CONCLUSION: Migraine may be positively associated with anxiety in middle-aged women. Further large-scale prospective cohort studies are needed to investigate the causality between migraine and anxiety.


Assuntos
Transtornos de Enxaqueca , Saúde da Mulher , Ansiedade/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Menopausa , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Estudos Prospectivos , Globulina de Ligação a Hormônio Sexual
18.
J Headache Pain ; 22(1): 106, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503443

RESUMO

BACKGROUND: Migraine is a primary headache disorder characterized by recurrent attacks that may have a significant impact on patients' daily life. Treatment options must often be re-evaluated in light of efficacy, tolerability and compliance issues. Few data on commonly applied treatment algorithms and treatment failures have existed in Germany in 2017/2018. The PANORAMA survey was designed to explore and characterize the migraine healthcare landscape and to demonstrate the medical treatment need at that time in Germany. METHODS: Three different questionnaires were used to assess the profile of the 119 participating centers, characterize migraine patients at centers and evaluate qualitative aspects of the current migraine healthcare situation from a physician´s professional perspective. Data were analyzed as observed and summarized by descriptive statistics. RESULTS: The results demonstrate that once referred to a migraine specialist, the majority of patients continue to be treated at a specialist. At specialized centers, 41.6 % of migraine patients receive prophylactic treatment. 45.4 % of prophylactic treatments are initiated with a beta-blocker and 28.1 % with an anti-epileptic. Pivotal factors to initiate prophylactic treatment are migraine attack frequency and intensity (58.0 %). Treatment decisions are largely based on prior / concomitant diseases and physical constitution of the patient (52.1 %). Following an inadequate treatment, most patients either switch substance class or discontinue prophylactic treatment. CONCLUSIONS: PANORAMA gives a comprehensive overview of the migraine healthcare landscape in Germany in 2017/2018, elucidates a lack of common treatment algorithms and reveals a high demand for defined therapy strategies and new prophylactic treatment going forwards.


Assuntos
Transtornos de Enxaqueca , Antagonistas Adrenérgicos beta/uso terapêutico , Anticonvulsivantes/uso terapêutico , Alemanha/epidemiologia , Humanos , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/prevenção & controle , Inquéritos e Questionários , Falha de Tratamento
19.
BMC Neurol ; 21(1): 345, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503456

RESUMO

BACKGROUND: The nature of COVID-19 pandemic measures has altered the clinical management of migraine, and has also created barriers to evaluate the impact of such measures of migraine patients. Using the Migraine Buddy smartphone application, we assessed the impact of the COVID-19 pandemic on migraine in users residing in the United States. METHODS: Migraine Buddy is a smartphone application by individuals to record their migraine headache episodes, characteristics, and coping mechanisms. For this study, anonymized self-reported data from 163,176 adult Migraine Buddy users in the United States between January 2020 and May 2020, were analyzed for migraines associated with stress. A stress-related migraine is defined as one in which stress or anxiety was reported as a trigger or symptom. A questionnaire on the impact of COVID-19 on migraine and its management was also completed by 923 users from the United States in the app between April 2020 and May 2020. RESULTS: 88% of the Migraine Buddy database extract and 84% of the respondents are female, with a mean age of 36.2 years. The proportion of stress-related migraine attacks peaked at 53% on March 21 to 23, although the number of migraine attacks decreased. This followed the declaration of the COVID-19 national emergency on March 13 and a spike in the number of COVID-19 cases in the United States. Questionnaire respondents felt that the following added more stress: social isolation (22.6%), information overdose (21.2%), access to essentials (food, medication, etc.) (18.7%), and financial concerns (17.8%). To help manage migraine during COVID-19, respondents suggested stress and diet coaching programs and resources (medical articles, etc.) (34.0%), having the option for home delivery of medication (30.6%) and tele-consulting (25.5%). CONCLUSION: Here, we report the change in the proportion of self-reported stress-related migraine in relation to evolution of the COVID-19 pandemic, as well as its impact of migraine management. Our data will help increase the understanding of patients' needs and help with planning and execution of mitigating strategies.


Assuntos
COVID-19 , Transtornos de Enxaqueca , Aplicativos Móveis , Adulto , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologia , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-34592795

RESUMO

Objective: To determine the prevalence, characteristics, and triggers of migraine and coping strategies used among medical students in Saudi Arabia.Methods: This cross-sectional descriptive study was conducted among undergraduate students in the College of Medicine of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Included students were in their second to sixth academic year of the Bachelor of Medicine or Bachelor of Surgery programs during the 2019-2020 academic year. The diagnosis of migraine was made according to the International Classification of Headache Disorders, Third Edition criteria.Results: A total of 396 students participated in the study; 238 (60.1%) were female and 158 (39.9%) were male. Their age ranged between 18 and 26 years old, with a mean age of 21.32 ± 1.659 years. Only 16 of 396 students fulfilled the criteria for migraine, with a prevalence of 4.04%. Migraine prevalence was higher in females (n = 11, 4.6%) compared to males (n = 5, 3.1%), with a female:male ratio of 1.5:1. The most common triggers associated with migraine were study-related stress (88%) and emotional-related stress (81%).Conclusions: This project was undertaken to evaluate prevalence, triggers, and coping strategies of migraine among medical students. The prevalence of migraine headache in this study was lower compared to other national and international universities, with a higher female to male ratio. Stress was a major trigger among our study population. The findings of this study will add to the growing body of literature on migraine.


Assuntos
Transtornos de Enxaqueca , Estudantes de Medicina , Adaptação Psicológica , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/epidemiologia , Prevalência , Arábia Saudita/epidemiologia , Adulto Jovem
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