目的:本研究旨在根据临床和心理生理特征对偏头痛患者进行分类。
方法:在这项观察性研究中,纳入了两组偏头痛患者(发作性/慢性).队列1:发作/围周阶段;队列2:发作间阶段。评估了以下变量:头痛频率;残疾;屈曲时的颈椎活动范围(AROM),扩展,右/左外侧屈,右/左旋转;压力-疼痛阈值(PPT)超过:颞,两个颈部区域(C1/C4椎体段),和两个远端无痛区域(手/腿)。使用K-means算法进行聚类分析。研究了集群之间的差异。
结果:队列-1:100名患者被纳入,并确定了两个集群。集群1.1(19%),集群-1.2(81%)。与群集1.2相比,群集1.1的男性百分比更高(p=0.037)和残疾更高(p=0.003)。集群1.2在屈曲方面减少了AROM,扩展,和左/右外侧屈曲(p<0.037),与集群1.1相比,所有区域的PPT值均较低(p<0.001)。队列2:98名患者被包括在内,并且确定了三个集群。集群-2.1(18%),集群-2.2(45%),和集群-2.3(37%)。群集2.1的男性比例高于群集2.2和2.3(p=0.009)。Cluster-2.3有较高的头痛频率,和残疾与Cluster-2.2(p<0.006)相比,与Cluster-2.1相比,残疾更高(p=0.010)。与簇-2.1和2.2相比,簇-2.3在所有方向上都减少了AROM(p<0.029)。与Cluster-1.1相比,Cluster-2.2和2.3在所有区域中具有较低的PPT值(p<0.001)。
结论:在周期/周期阶段,根据临床和心理物理特征确定了两个集群,一组没有表现出心理物理障碍,一组表现出疼痛敏感性和颈部肌肉骨骼功能障碍。在中间阶段,可以确定三个集群,一组没有表现出心理物理障碍,一种疼痛敏感性增加,和一个增加疼痛敏感性和颈部肌肉骨骼功能障碍。
This study aims to profile migraine patients according clinical and psychophysical characteristics.
In this observational study, two cohorts of migraine patients(episodic/chronic) were included. Cohort-1: ictal/perictal phase; Cohort-2: interictal phase.The following variables were assessed: headache frequency; disability; cervical active range of motion(AROM) in flexion, extension, right/left lateral flexion, right/left rotation; pressure-pain threshold(PPT) over: temporalis, two cervical areas(C1/C4 vertebral segments), and two distal pain-free areas(hand/leg). Cluster analysis was performed using the K-means algorithm. Differences across clusters were investigated.
Cohort-1: 100 patients were included, and two clusters were identified. Cluster-1.1 (19%), Cluster-1.2 (81%). Cluster 1.1 had a higher percentage of men (P = .037) and higher disability (P = .003) compared to Clusters 1.2. Cluster 1.2 had reduced AROM in flexion, extension, and left/right lateral flexion (P < .037), and lower PPT value in all areas (P < .001) compared to Cluster 1.1. Cohort-2: 98 patients were included and three clusters were identified. Cluster-2.1(18%), Cluster-2.2(45%), and Cluster-2.3(37%). Cluster-2.1 had a higher percentage of men compared to clusters-2.2 and 2.3 (P = .009). Cluster-2.3 had higher headache frequency, and disability compared to Cluster-2.2 (P < .006), and higher disability compared to Cluster-2.1 (P = .010). Cluster-2.3 had reduced AROM in all directions compared to Clusters-2.1 and 2.2 (P < .029). Clusters-2.2 and 2.3 have lower PPT values in all areas compared to Cluster-1.1 (P < .001).
In the Ictal/perictal phase, two clusters were identified according to clinical and psychophysical characteristics, with one group showing no psychophysical impairment and one with increased pain-sensitivity and cervical musculoskeletal-dysfunctions.In the interictal phase, three clusters could be identified, with one group showing no psychophysical impairment, one increased pain-sensitivity, and one increased pain sensitivity and cervical musculoskeletal-dysfunctions.