使用多种进展定义的偏头痛进展率和风险因素:纵向OVERCOME (美国) 研究的结果
Dawn C Buse1, E Jolanda Muenzel2, Anthony J Zagar2
1Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
Headache
|March 14, 2025
概括
偏头痛的进展可以使用新的定义来确定,这些定义考虑了头痛天和残疾. 从不使用预防药物和患有抑郁症是偏头痛恶化的关键风险因素.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 偏头痛的进展传统上是由每月头痛天数 (MHDs) 的增加来定义的.
- 这种传统的定义可能不涵盖偏头痛恶化的全谱,包括残疾和功能影响.
- 需要替代的定义,以更好地理解和识别偏头痛的进展.
研究的目的:
- 用传统和替代定义估计偏头痛进展率.
- 在一个大,纵向队列中确定偏头痛进展的预测因素.
- 扩大对偏头痛进展的理解,超越情节性至慢性偏头痛过渡.
主要方法:
- 偏头痛流行病学,治疗和护理观察调查 (OVERCOME) 研究跟踪了11634名偏头痛成年人.
- 使用三个定义来评估进展情况:传统的偶发性偏头痛 (EM) 转变为慢性偏头痛 (CM),MHD增加≥5,以及偏头痛残疾评估 (MIDAS) 增加≥5点.
- 从67个候选特征中确定了进展的预测因素.
主要成果:
- 在1年的随访中,4.7%的EM参与者进展到CM.
- 在使用替代定义时观察到更高的进展率:MHD进展率为9.6%,MIDAS进展率为21.7%.
- 从未使用过预防性偏头痛药物和抑郁的存在与所有定义中偏头痛进展的几率增加有关.
结论:
- 偏头痛进展的替代定义,包括MHD和残疾,提供了一个更广泛的视角.
- 从不使用预防药物和患有抑郁症是偏头痛进展的重要风险因素.
- 这些发现可以改善对患病进展风险的个体的识别,并为预防策略提供信息.
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