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Published on: June 2, 2014
Physical impairment during and between migraine attacks: A daily diary study of patients with chronic migraine
David J Whitaker1, Gina M Dumkrieger1, Joseph G Hentz2
1Department of Neurology, Mayo Clinic, Phoenix, USA.
Objective:
While a substantial body of research describes the disabling impacts of migraine attacks, less research has described the impacts of migraine on physical functioning between migraine attacks. The objective of this study is to describe physical impairment during and between migraine attacks as a dimension of burden experienced by people living with chronic migraine.
Methods:
The physical impairment domain of the Migraine Physical Function Impact Diary was recorded in headache diaries from the Medication Overuse Treatment Strategy trial. Days with moderate to severe headache were used to approximate migraine attacks. Factor analysis and regression analysis were used to describe associations between migraine and physical impairment.
Results:
77,662 headache diary entries from 720 participants were analyzed, including 25,414 days with moderate to severe headache, 19,149 days with mild headache, and 33,099 days with no headache. Mean physical impairment score was 41.5 (SD = 26.1) on days with moderate to severe headache, 12.8 (SD = 15.0) on days with mild headache, and 5.2 (SD = 13.1) on days with no headache. Physical impairment on days with mild headache and days with no headache was significantly associated with days since last moderate to severe headache, physical impairment with last moderate to severe headache, mild headache (compared to no headache), depression, hypersensitivities and cranial autonomic symptoms.
Conclusions:
Physical impairment occurs on migraine and non-migraine days. Study participants with frequent headaches, symptoms of depression, hypersensitivities and cranial autonomic symptoms experience physical impairment at a higher rate on days with no headache and days with mild headache.Clinical Trial Registration: ClinicalTrials.gov (NCT02764320).
Insights
Migraine significantly impacts physical functioning not only during attacks but also on non-migraine days. Factors like headache frequency and associated symptoms increase impairment even on headache-free days.
Area of Science:
- Neurology
- Pain Management
- Patient-Reported Outcomes
Background:
- Migraine attacks cause significant disability, but physical functioning between attacks is less understood.
- Chronic migraine (CM) presents a substantial burden, necessitating a deeper understanding of its impact on daily physical function.
Purpose of the Study:
- To characterize physical impairment during and between migraine attacks in individuals with chronic migraine.
- To identify factors associated with physical impairment on non-migraine days.
Main Methods:
- Analysis of 77,662 headache diary entries from the Medication Overuse Treatment Strategy trial.
- Utilized factor analysis and regression analysis to examine associations between migraine characteristics and physical impairment.
- Defined migraine attacks as days with moderate to severe headache.
Main Results:
- Physical impairment scores were significantly higher on moderate/severe headache days (41.5) compared to mild (12.8) and no headache days (5.2).
- Impairment on mild and no headache days correlated with recent severe headache, depression, hypersensitivities, and cranial autonomic symptoms.
- 720 participants contributed data, with 25,414 moderate/severe headache days analyzed.
Conclusions:
- Physical impairment is present on both migraine and non-migraine days in individuals with chronic migraine.
- Frequent headaches, depression, hypersensitivities, and cranial autonomic symptoms are linked to higher physical impairment on days without headache or with mild headache.
