Predictors of allodynia in persons with migraine: Results from the Migraine in America Symptoms and Treatment (MAST) study
Predictors of allodynia in persons with migraine: Results from the Migraine in America Symptoms and Treatment (MAST) study
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DOI：
10.1177/0333102418825346
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发表时间：
2019-06-01
期刊：
影响因子：
4.9
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Dodick, David W.;Reed, Michael L.;Lipton, Richard B.
背景皮肤异常性疼痛是偏头痛的一个常见临床特征，与急性偏头痛治疗的疗效降低和疾病进展的风险增加有关。目的确定与偏头痛成人样本中异常性疼痛相关的因素。方法使用在线调查面板来确定偏头痛成人平均至少1个月头痛日超过前3个月。获得了社会人口统计学、头痛频率、头痛强度、偏头痛症状严重程度、药物使用、抑郁和焦虑以及皮肤异常性疼痛（通过异常性疼痛症状检查表）的数据。二元逻辑模型预测异常性疼痛的存在。计算比值比和95%可信区间（CI）。结果共有15,133名偏头痛患者符合入选标准。平均年龄为43.1岁，73.0%为女性，81.0%为白人。异常性疼痛发生率为39.9%。完全校正的模型，控制了社会人口统计学和头痛特征，表明异常性疼痛与偏头痛症状严重程度评分较高显著相关（比值比1.17，置信区间1.15，1.19）和更严重的疼痛强度（比值比1.11，置信区间1.08，1.14）;可能的抑郁和/或焦虑（比值比1.83，置信区间1.67，2.00）;和过度使用急性药物（比值比1.23，置信区间1.09，1.38）。每月头痛天数增加了异常性疼痛的可能性，但在充分调整model.Conclusion衰减的效果在一个有代表性的美国成年人偏头痛的样本，异常性疼痛和头痛的频率和强度，焦虑和/或抑郁，症状严重程度，急性药物过度使用之间有显着的关联。
Background Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression.Objective Identify factors associated with allodynia in a sample of adults with migraine.Methods An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated.Results In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model.Conclusion In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.