Fibromyalgia in migraine: a retrospective cohort study

Area of Science:

• Neurology
• Pain Medicine
• Psychiatry

Background:

• Migraine is a prevalent and disabling neurological disorder.
• Fibromyalgia frequently co-occurs with migraine, exacerbating patient disability.
• Understanding the impact of comorbid fibromyalgia on migraine patients is crucial for effective management.

Purpose of the Study:

• To investigate whether patients with comorbid fibromyalgia and migraine report increased depressive symptoms.
• To assess if comorbid fibromyalgia leads to greater headache-related disability.
• To determine if headache intensity is higher in patients with both conditions compared to migraine alone.

Main Methods:

• A matched cohort study comparing 157 patients with comorbid fibromyalgia and migraine to 471 controls with migraine only.
• Utilized data from a prospectively maintained headache database and electronic medical records at Mayo Clinic Rochester.
• Assessed depressive symptoms using PHQ-9, headache intensity, and migraine-related disability via MIDAS.

Main Results:

• Patients with comorbid fibromyalgia reported significantly higher PHQ-9 scores for depressive symptoms (OR 1.08, p < .0001).
• Headache intensity scores were significantly higher in the comorbid group (OR 1.149, p = .007).
• While not statistically significant in the primary analysis (OR 1.002, p = .075), patients with fibromyalgia were more likely to score higher for disability (OR 1.23, p = .004).

Conclusions:

• Comorbid fibromyalgia in migraine patients is associated with increased depressive symptoms and higher headache intensity.
• These patients are also more likely to experience severe headache-related disability.
• Clinicians should consider screening migraine patients with moderate-to-severe depression or high headache intensity for comorbid fibromyalgia.