Prevalence and characteristics of allodynia in headache sufferers - A population study
Prevalence and characteristics of allodynia in headache sufferers - A population study
复制标题
DOI：
10.1212/01.wnl.0000310645.31020.b1
复制
发表时间：
2008-04-22
期刊：
影响因子：
9.9
通讯作者：
Lipton, R. B.
中科院分区：
文献类型：
--
作者：
Bigal, M. E.;Ashina, S.;Lipton, R. B.
目的：作者估计了普通人群中原发性头痛患者皮肤异常性疼痛（CA）的患病率和严重程度。方法：我们向之前从人群中确定的24，000名头痛患者的随机样本邮寄了调查问卷。问卷包括经验证的异常性疼痛症状检查表（ASC）以及头痛特征、残疾和合并症的测量。我们使用头痛诊断、头痛的频率和严重程度以及残疾作为logistic回归的预测变量，将异常性疼痛作为结果建模。协变量包括人口统计学变量、合并症、预防性药物的使用和阿片类药物的使用。任何严重程度的CA（ASC评分>= 3）的患病率随头痛类型而变化。转化型偏头痛（TM，68.3%）的患病率显著高于发作性偏头痛（63.2%，p < 0.01），并且与可能的偏头痛（42.6%）、其他慢性日常头痛（36.8%）和严重发作性紧张型头痛（36.7%）相比，这两组的患病率显著升高。严重CA（ASC评分>= 9）的患病率在TM中也最高（28.5%），其次是偏头痛（20.4%）、可能的偏头痛（12.3%）、其他慢性日常头痛（6.2%）和严重发作性紧张型头痛（5.1%）。在偏头痛和TM组中，CA的患病率在女性中较高，并随残疾评分增加而增加。在偏头痛患者中，CA随着头痛频率和体重指数的增加而增加。在所有组中，ASC评分较高的个人与major depression.Conclusions：皮肤异常性疼痛（CA）是更常见和更严重的转化偏头痛和偏头痛比其他原发性头痛。在偏头痛患者中，CA与女性性别、头痛频率、体重指数增加、残疾和抑郁有关。
Objective: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population.Methods: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids.Results: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score >= 3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score >= 9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression.Conclusions: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.