Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course

Ilya Kister, A B Caminero, T S Monteith, A Soliman, T E Bacon, J H Bacon, J T Kalina, M Inglese, J Herbert, R B Lipton, Ilya Kister, A B Caminero, T S Monteith, A Soliman, T E Bacon, J H Bacon, J T Kalina, M Inglese, J Herbert, R B Lipton

Abstract

The objectives of this study were: (1) to assess relative frequency of migraine in multiple sclerosis (MS) patients using the validated self-administered diagnostic questionnaire, and to compare the migraine rates in MS outpatients to age- and gender-matched historical population controls; (2) to compare clinical and radiographic characteristics in MS patients with migraine and headache-free MS patients. We conducted a cross-sectional study to assess the demographic profiles, headache features and clinical characteristics of MS patients attending a MS clinic using a questionnaire based on the American Migraine Prevalence and Prevention (AMPP) study. We compared the relative frequency of migraine in MS clinic patients and AMPP cohort. We also compared clinical and radiographic features in MS patients with migraine to an MS control group without headache. Among 204 MS patients, the relative frequency of migraine was threefold higher than in population controls both for women [55.7 vs. 17.1%; prevalence ratio (PR) =3.26, p<0.001] and men (18.4 vs. 5.6%; PR=3.29, p<0.001). In a series of logistic regression models that controlled for age, gender, disease duration, β-interferon use, and depression, migraine in MS patients was significantly associated (p<0.01) with trigeminal and occipital neuralgia, facial pain, Lhermitte's sign, temporomandibular joint pain, non-headache pain and a past history of depression. Migraine status was not significantly associated with disability on patient-derived disability steps scale or T2 lesion burden on brain MRI. Migraine is three-times more common in MS clinic patients than in general population. MS-migraine group was more symptomatic than the MS-no headache group.

References

    1. Compston N, McAlpine D. Some aspects of the natural history of disseminated sclerosis. Q J Med. 1952;21:135–167.
    1. Watkins SM, Espir M. Migraine and multiple sclerosis. J Neurol Neurosurg Psychiatry. 1969;32:35–37. doi: 10.1136/jnnp.32.1.35.
    1. Rolak LA, Brown S. Headaches and multiple sclerosis: a clinical study and review of the literature. J Neurol. 1990;237:300–302. doi: 10.1007/BF00314746.
    1. Headache Classification Committee of the International Headache Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain, 2nd edn. Cephalalgia. 2004;24(Suppl 1):1–116.
    1. Nicoletti A, Patti F, Lo Fermo S, Liberto A, Castiglione A, Laisa P, Garifoli A, et al. Headache and multiple sclerosis: a population-based case–control study in Catania, Sicily. Cephalalgia. 2008;28:1163–1169. doi: 10.1111/j.1468-2982.2008.01662.x.
    1. Vacca G, Marano E, Brescia Morra V, Lanzillo R, Vito M, Parente E, Orefice G. Multiple sclerosis and headache co-morbidity. A case–control study. Neurol Sci. 2007;28:133–135. doi: 10.1007/s10072-007-0805-1.
    1. Putzki N, Pfriem A, Limmroth V, Yaldizli O, Tettenborn B, Diener HC, Katsarava Z. Prevalence of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. Eur J Neurol. 2009;16:262–267. doi: 10.1111/j.1468-1331.2008.02406.x.
    1. D’Amico D, La Mantia L, Rigamonti A, Usai S, Mascoli N, Milanese C, Bussone G. Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia. 2004;24:980–984. doi: 10.1111/j.1468-2982.2004.00790.x.
    1. Villani V, Prosperini L, Ciuffoli A, Pizzolato R, Salvetti M, Pozzilli C, Sette G. Primary headache and multiple sclerosis: preliminary results of a prospective study. Neurol Sci. 2008;29(Suppl 1):S146–S148. doi: 10.1007/s10072-008-0908-3.
    1. Pöllmann W, Erasmus LP, Feneberg W, Straube A. The effect of glatiramer acetate treatment on pre-existing headaches in patients with MS. Neurology. 2006;66:275–277. doi: 10.1212/01.wnl.0000194317.75449.91.
    1. Pöllmann W, Erasmus LP, Feneberg W, Then Bergh F, Straube A. Interferon beta but not glatiramer acetate therapy aggravates headaches in MS. Neurology. 2002;59:636–639.
    1. Marrie RA, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T. Comorbidity delays diagnosis and increases disability at diagnosis in MS. Neurology. 2009;72:117–124. doi: 10.1212/01.wnl.0000333252.78173.5f.
    1. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343–349. doi: 10.1212/01.wnl.0000252808.97649.21.
    1. Swartz KL, Pratt LA, Armenian HK, Lee LC, Eaton WW. Mental disorders and the incidence of migraine headaches in a community sample: results from the Baltimore Epidemiologic Catchment area follow-up study. Arch Gen Psychiatry. 2000;57:945–950. doi: 10.1001/archpsyc.57.10.945.
    1. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry. 1990;47:849–853.
    1. Breslau N, Lipton RB, Stewart WF, Schultz LR, Welch KM. Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology. 2003;60:1308–1312.
    1. Lipton RB, Scher AI, Kolodner K, Liberman J, Steiner TJ, Stewart WF. Migraine in the United States: epidemiology and patterns of health care use. Neurology. 2002;58:885–894.
    1. Stewart WF, Lipton RB, Whyte J, Dowson A, Kolodner K, Liberman JN, Sawyer J. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology. 1999;53:988–994.
    1. Hohol MJ, Orav EJ, Weiner HL. Disease steps in multiple sclerosis: a simple approach to evaluate disease progression. Neurology. 1995;45:251–255.
    1. Diamond S, Bigal ME, Silberstein S, Loder E, Reed M, Lipton RB. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache. 2007;47:355–363.
    1. Aurora SK, Wilkinson F. The brain is hyperexcitable in migraine. Cephalalgia. 2007;27:1442–1453. doi: 10.1111/j.1468-2982.2007.01502.x.
    1. Burstein R, Yarnitsky D, Goor-Aryeh I, Ransil BJ, Bajwa ZH. An association between migraine and cutaneous allodynia. Ann Neurol. 2000;47:614–624. doi: 10.1002/1531-8249(200005)47:5<614::AID-ANA9>;2-N.
    1. Kitaj MB, Klink M. Pain thresholds in daily transformed migraine versus episodic migraine headache patients. Headache. 2005;45:992–998. doi: 10.1111/j.1526-4610.2005.05179.x.
    1. Mathew NT, Kailasam J, Seifert T. Clinical recognition of allodynia in migraine. Neurology. 2004;63:848–852.
    1. Scher AI, Stewart WF, Lipton RB. The comorbidity of headache with other pain syndromes. Headache. 2006;46:1416–1423. doi: 10.1111/j.1526-4610.2006.00584.x.
    1. Gee JR, Chang J, Dublin AB, Vijayan N. The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache. 2005;45:670–677. doi: 10.1111/j.1526-4610.2005.05136.x.
    1. Tietelbaum P, Cytawa J. Spreading depression and recovery from lateral hypothalamic damage. Science. 1965;147:61–63. doi: 10.1126/science.147.3653.61.
    1. Bigal ME, Ashina S, Burstein R, Reed ML, Buse D, Serrano D, Lipton RB, et al. Prevalence and characteristics of allodynia in headache sufferers: a population study. Neurology. 2008;70:1525–1533. doi: 10.1212/01.wnl.0000310645.31020.b1.
    1. Berkson J. Limitation to application of four-fold table analysis to hospital data. Biom Bull. 1946;2:47–53. doi: 10.2307/3002000.
    1. La Mantia L, D’Amico D, Rigamonti A, Mascoli N, Bussone G, Milanese C. Interferon treatment may trigger primary headaches in multiple sclerosis patients. Mult Scler. 2006;12:476–480. doi: 10.1191/1352458506ms1298oa.

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