PDF(Pubmed)
Abstract：
OBJECTIVE: The underpinning biologics of migraine chronification are not well understood. We aim to investigate the role of the cumulative burden of stress, namely the allostatic load, in migraine chronification.
METHODS: This was a cross-sectional study. The allostatic load was measured with a composite multi-system score (BALI: Bologna Allostatic Load Index), evaluating 20 biomarkers representing four physiological systems: immune, metabolic, cardiovascular, and neuroendocrinological systems. BALI score was subdivided into high score and low score based on the distribution in controls. Migraine patients were included and subclassified into low-frequency episodic migraine group (low-EM group), high-frequency episodic migraine group (high-EM group), and chronic migraine group (CM group).
RESULTS: The distribution of BALI high-score increased in parallel with headache attacks monthly frequency: 16% in low-EM group (n = 10), 24% in high-EM group (n = 12), and 40% in CM group (n = 21) (p = 0.017). In a multivariable analysis, the odds ratio of having a high-score BALI in CM patients (vs. low-EM patients) was 2.78 (95% CI 1.07-7.22; p = 0.036). Individual BALI biomarkers values which were significantly different among migraine subgroups included systolic blood pressure (p = 0.018), diastolic blood pressure (p < 0.001), and heart rate (p = 0.019).
CONCLUSIONS: Our study substantiates this emerging concept of migraine chronification as an allostatic disorder.
METHODS: This was a cross-sectional study. The allostatic load was measured with a composite multi-system score (BALI: Bologna Allostatic Load Index), evaluating 20 biomarkers representing four physiological systems: immune, metabolic, cardiovascular, and neuroendocrinological systems. BALI score was subdivided into high score and low score based on the distribution in controls. Migraine patients were included and subclassified into low-frequency episodic migraine group (low-EM group), high-frequency episodic migraine group (high-EM group), and chronic migraine group (CM group).
RESULTS: The distribution of BALI high-score increased in parallel with headache attacks monthly frequency: 16% in low-EM group (n = 10), 24% in high-EM group (n = 12), and 40% in CM group (n = 21) (p = 0.017). In a multivariable analysis, the odds ratio of having a high-score BALI in CM patients (vs. low-EM patients) was 2.78 (95% CI 1.07-7.22; p = 0.036). Individual BALI biomarkers values which were significantly different among migraine subgroups included systolic blood pressure (p = 0.018), diastolic blood pressure (p < 0.001), and heart rate (p = 0.019).
CONCLUSIONS: Our study substantiates this emerging concept of migraine chronification as an allostatic disorder.
摘要：
目的：偏头痛慢性化的基础生物制剂尚不清楚。我们的目的是调查累积压力负担的作用，即静载荷，偏头痛的慢性化。
方法：这是一项横断面研究。用复合多系统评分（BALI：博洛尼亚合金载荷指数）测量合金静载荷，评估代表四个生理系统的20个生物标志物：免疫，新陈代谢，心血管,和神经内分泌系统。根据对照中的分布，将BALI评分细分为高分和低分。偏头痛患者被纳入并细分为低频发作性偏头痛组（低EM组），高频发作性偏头痛组（高EM组），慢性偏头痛组(CM组)。
结果：BALI高分的分布与头痛发作的每月频率平行增加：低EM组（n=10）为16％，高EM组24%(n=12)，CM组为40%(n=21)(p=0.017)。在多变量分析中，CM患者具有高得分BALI的比值比(与低EM患者）为2.78（95%CI1.07-7.22；p=0.036）。在偏头痛亚组之间存在显著差异的个体BALI生物标志物值包括收缩压(p=0.018),舒张压（p<0.001），和心率（p=0.019）。
结论：我们的研究证实了偏头痛慢性化是一种同种异体疾病的新兴概念。
方法：这是一项横断面研究。用复合多系统评分（BALI：博洛尼亚合金载荷指数）测量合金静载荷，评估代表四个生理系统的20个生物标志物：免疫，新陈代谢，心血管,和神经内分泌系统。根据对照中的分布，将BALI评分细分为高分和低分。偏头痛患者被纳入并细分为低频发作性偏头痛组（低EM组），高频发作性偏头痛组（高EM组），慢性偏头痛组(CM组)。
结果：BALI高分的分布与头痛发作的每月频率平行增加：低EM组（n=10）为16％，高EM组24%(n=12)，CM组为40%(n=21)(p=0.017)。在多变量分析中，CM患者具有高得分BALI的比值比(与低EM患者）为2.78（95%CI1.07-7.22；p=0.036）。在偏头痛亚组之间存在显著差异的个体BALI生物标志物值包括收缩压(p=0.018),舒张压（p<0.001），和心率（p=0.019）。
结论：我们的研究证实了偏头痛慢性化是一种同种异体疾病的新兴概念。
