Cutaneous allodynia as a predictor of migraine chronification
Cutaneous allodynia as a predictor of migraine chronification
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DOI：
10.1093/brain/awt251
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发表时间：
2013-11-01
期刊：
影响因子：
14.5
通讯作者：
Terwindt, Gisela M.
中科院分区：
文献类型：
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作者：
Louter, Mark A.;Bosker, Johanneke E.;Terwindt, Gisela M.
皮肤过敏症是偏头痛发作时的常见特征，被认为是中枢敏感化的临床标志。在一项纵向研究中，我们想要调查偏头痛患者的痛觉异常是否是偏头痛天数增加的预测因素。我们纳入了3029名明确的、基于网络的偏头痛患者(86%为女性，平均年龄为42.8+/-11.4岁，61%为无先兆的偏头痛)。问卷内容包括偏头痛特征(包括痛觉异常)、抑郁和人口统计学因素。偏头痛天数被测量了两次。使用了多变量回归模型，校正了与偏头痛发作次数或偏头痛天数之间的关系有关的其他因素，特别关注抑郁症。在所有2331名符合条件的偏头痛患者中，1624名(70%)有痛觉异常。终生抑郁是痛觉异常的独立危险因素(优势比1.52，95%可信区间1.26-1.84)，以及女性、发病年龄低和偏头痛发作频率高。对纵向数据的分析(对于有6个月随访期的偏头痛患者)表明，除了已知的危险因素(发病年龄低、偏头痛基线天数高和抑郁)外，在平均93+/-30周的随访期(中位数103周，范围26-160周)中，疼痛异常是偏头痛天数增加的独立预测因素。皮肤过敏症是偏头痛慢性化的危险因素，可能需要预防性治疗策略。
Cutaneous allodynia is a common feature accompanying migraine attacks and considered a clinical marker for central sensitization. In a longitudinal study, we wanted to investigate if allodynia in migraine patients is a predictor of increasing frequency of migraine days. We included 3029 well-defined, web-based migraine patients (86% female, mean age 42.8 +/- 11.4 years, 61% migraine without aura). Questionnaires on migraine characteristics (including allodynia), depression and demographic factors were applied. The number of migraine days was measured twice. Multivariate regression models were used, with correction for other factors that are involved in the relation between allodynia and the number of migraine attacks or migraine days, with specific focus on depression. Of all 2331 eligible migraine patients, 1624 (70%) had allodynia. Lifetime depression was an independent risk factor for allodynia (odds ratio 1.52, 95% confidence interval 1.26-1.84), as well as female gender, low age at onset, and high migraine attack frequency. Analysis of the longitudinal data (in migraineurs with a follow-up period of > 6 months) showed that, apart from the known risk factors (low age at onset, high baseline number of migraine days, and depression), allodynia was an independent predictor for increase in number of migraine days over a mean follow-up period of 93 +/- 30 weeks (median 103 weeks, range 26-160 weeks). Cutaneous allodynia is a risk factor for migraine chronification and may warrant preventive treatment strategies.