目的:在多国慢性偏头痛流行病学和结果-国际(CaMEO-I)研究中,评估偏头痛患者头痛时颈部疼痛的患病率和影响。
背景:偏头痛患者的颈部疼痛非常普遍,并导致残疾。
方法:CaMEO-I是一个前瞻性的,横截面,在加拿大进行的基于网络的研究,法国,德国,Japan,英国,和美国。来自每个国家的具有人口统计学代表性的参与者样本完成了一项筛查调查,以评估头痛特征。根据修订后的国际头痛疾病分类,头痛的受访者被确定为偏头痛或非偏头痛。第三版,标准;偏头痛患者完成了一项详细的调查,包括偏头痛特异性评估。根据是否存在颈痛伴头痛(NPWH)对结果进行分层。对于这些分析,数据汇集了6个国家.
结果:在过去12个月内报告头痛的51,969名受访者中,14,492(27.9%)被归类为偏头痛;其余的37,477(72.1%)患有非偏头痛。总的来说,9896/14,492(68.3%)的偏头痛受访者报告NPWH,显着高于(p<0.001)报告NPWH的非偏头痛性头痛的受访者比例(13,536/37,477[36.1%])。在偏头痛的受访者中,患有NPWH的患者与没有NPWH的患者相比,中度至重度残疾更为普遍(47.7%[4718/9896]与28.9%,p<0.001)。有NPWH的受访者与没有NPWH的受访者相比,工作效率损失也显著增加,中位数(四分位数范围[IQR])为50.0(20.0,71.3)与30.0(0.0,60.0)(p<0.001),生活质量较低(偏头痛特定生活质量问卷2.1版,中位数[IQR]角色功能限制性领域评分60.0[42.9,74.3]vs.68.6[54.3,82.9],p<0.001),抑郁和焦虑症状的患病率较高(抑郁,40.2%[3982/9896]vs.28.2%[1296/4596],p<0.001);焦虑,41.2%[4082/9896]vs.29.2%[1343/4596],p<0.001),头痛期间皮肤异常性疼痛的患病率更高(54.0%[5345/9896]vs.36.6%[1681/4596],p<0.001),急性治疗优化不良的患病率较高(61.1%[5582/9129]vs.53.3%[2197/4122],p<0.001)。
结论:近70%的偏头痛患者报告了NPWH。患有偏头痛并在头痛期间颈部疼痛的人有更大的残疾,抑郁症,焦虑,和皮肤异常疼痛(在头痛期间)比那些在头痛期间没有颈部疼痛的人。他们还降低了生活质量和工作效率,与没有颈部疼痛的患者相比,对急性治疗的反应较差。
To assess the prevalence and impact of neck pain during headache among respondents with migraine in the multicountry Chronic Migraine Epidemiology and Outcomes - International (CaMEO-I)
Study.
Neck pain among individuals with migraine is highly prevalent and contributes to disability.
The CaMEO-I was a prospective, cross-sectional, web-based
study conducted in Canada, France, Germany, Japan, United Kingdom, and the United States. A demographically representative sample of participants from each country completed a screening survey to evaluate headache characteristics. Respondents with headache were identified as having migraine or non-migraine headache based on modified International Classification of Headache Disorders, third edition, criteria; those with migraine completed a detailed survey with migraine-specific assessments. Results were stratified by the presence or absence of neck pain with headache (NPWH). For these analyses, data were pooled across the six countries.
Of 51,969 respondents who reported headache within the past 12 months, 14,492 (27.9%) were classified as having migraine; the remaining 37,477 (72.1%) had non-migraine headache. Overall, 9896/14,492 (68.3%) of respondents with migraine headache reported NPWH, which was significantly higher (p < 0.001) than the proportion of respondents with non-migraine headache who reported NPWH (13,536/37,477 [36.1%]). Among respondents with migraine, moderate-to-severe disability was significantly more prevalent for those with NPWH versus without (47.7% [4718/9896] vs. 28.9%, p < 0.001). Respondents with NPWH versus without also had significantly greater work productivity losses, at a median (interquartile range [IQR]) of 50.0 (20.0, 71.3) vs. 30.0 (0.0, 60.0) (p < 0.001), lower quality of life (Migraine-Specific Quality of Life questionnaire version 2.1, median [IQR] Role Function-Restrictive domain score 60.0 [42.9, 74.3] vs. 68.6 [54.3, 82.9], p < 0.001), higher prevalence of depression and anxiety symptoms (depression, 40.2% [3982/9896] vs. 28.2% [1296/4596], p < 0.001); anxiety, 41.2% [4082/9896] vs. 29.2% [1343/4596], p < 0.001), higher prevalence of cutaneous allodynia during headache (54.0% [5345/9896] vs. 36.6% [1681/4596], p < 0.001), and higher prevalence of poor acute treatment optimization (61.1% [5582/9129] vs. 53.3% [2197/4122], p < 0.001).
Nearly 70% of respondents with migraine reported NPWH. Individuals with migraine with neck pain during their headaches had greater disability, depression, anxiety, and cutaneous allodynia (during headache) than those without neck pain during their headaches. They also had diminished quality of life and work productivity, and poorer response to acute treatment compared with those without neck pain.