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Published on: June 2, 2014
Predictors of migraine interictal burden: The hidden role of subjective memory complaints
Filipa Dourado Sotero1,2,3, João Nobre2, Beatriz Nunes Vicente1
1Neurology Department, Hospital de Santa Maria, Centro Hospitalar e Universitário Lisboa Norte, Lisbon, Portugal.
Background:
The "interictal burden of migraine" (MIB) is a new concept that encompasses the overall impact of the disease between migraine episodes. However, the factors that contribute to this interictal burden are still unclear.
Objective:
This study aimed to identify explanatory factors of interictal burden in patients with migraine.
Methods:
This prospective cross-sectional observational including 200 patients with migraine (92% [n = 184] female, with a mean [standard deviation] age of 44.8 [12] years, 53% [n = 106] with chronic migraine) completed a clinical and questionnaire assessment targeting MIB, migraine impact, and depressive and cognitive complaints.
Results:
More than three-fourths (76% [n = 152]) of patients had moderate-to-severe interictal burden. Higher interictal burden (MIB Scale ≥2) was associated with higher headache frequency (eight vs. 14, p = 0.001) and intensity (headache index score 17.0 vs. 30.0, p = 0.002), higher headache impact (six-item Headache Impact Test score 59.2 vs. 63.9, p = 0.001), and more subjective memory complaints (Subjective Memory Complaints Questionnaire [SMC] score 9.0 vs. 4.5, p = 0.001), as well as anxiety (Hospital Anxiety and Depression Scale (HADS)-Anxiety score 5 vs. 10, p < 0.001) and depression symptoms (HADS-Depression score 5 vs. 8, p < 0.001). Once accounted for these potential explanatory variables, subjective memory complaints and impact of headache during ictal phase remained as individual determinants of the interictal burden, with SMC explaining 15% (odds ratio 1.15, 95% confidence interval 1.03-1.28; p = 0.010) of the interictal burden.
Conclusion:
This finding highlights the need to consider cognitive complaints as part of the construct of interictal burden of these patients to refine the focus of their management.
Insights
Migraine patients experience significant interictal burden, often linked to cognitive complaints. Addressing subjective memory issues is key to managing the overall impact of migraine between attacks.
Area of Science:
- Neurology
- Clinical Psychology
Background:
- The interictal burden of migraine (MIB) describes the disease's impact between attacks.
- Factors contributing to MIB are not well understood.
Purpose of the Study:
- To identify factors that explain the interictal burden in migraine patients.
- To investigate the role of cognitive and mood complaints in MIB.
Main Methods:
- Prospective cross-sectional observational study of 200 migraine patients.
- Assessment included MIB, migraine impact, and depressive, anxiety, and cognitive complaints.
- Patients were predominantly female (92%) with a mean age of 44.8 years, and 53% had chronic migraine.
Main Results:
- 76% of patients reported moderate-to-severe interictal burden.
- Higher MIB correlated with increased headache frequency, intensity, and impact.
- Subjective memory complaints, anxiety, and depression symptoms were associated with higher MIB.
Conclusions:
- Subjective memory complaints and headache impact during attacks independently predict interictal burden.
- Cognitive complaints are crucial components of interictal burden and should guide migraine management.
