0000000000267895
AUTHOR
Gian Camillo Manzoni
Chronification of migraine: what clinical strategies to combat it?
Once migraine becomes chronic and has transformed into a form of headache that occurs daily or almost, the treatment options available are few and complex. This makes it important to take action before this point is reached, using all the measures that can be obtained from our current knowledge of chronic migraine (or transformed migraine) on the one hand, and on the potential factors of chronification (or transformation) on the other. Therefore, in order to reduce the risk of migraine chronification, it would appear important to: (a) administer suitable preventive treatments for subjects who have been suffering from migraines ≥4 days a month for ≥3 months; (b) take special care not to over…
Headache, anxiety and depressive disorders: the HADAS study.
The objective of this paper was to assess prevalence and characteristics of anxiety and depression in migraine without aura and tension-type headache, either isolated or in combination. Although the association between headache and psychiatric disorders is undisputed, patients with migraine and/or tension-type headache have been frequently investigated in different settings and using different tests, which prevents meaningful comparisons. Psychiatric comorbidity was tested through structured interview and the MINI inventory in 158 adults with migraine without aura and in 216 persons with tension-type headache or migraine plus tension-type headache. 49 patients reported psychiatric disorders…
Chronic headache and body mass index: a case-control study.
In recent years clinical research has focused on the possible role played by obesity as a risk factor for headache chronification.The aim of this case-control, hospital-based study was to evaluate: the prevalence of overweight and obesity in subjects with chronic migraine (CM) and chronic tension-type headache (CTTH); and the possible correlations between body mass index (BMI) and both headache types. Materials and methods: We studied 79 patients, 46 with CM and 33 with CTTH, consecutively referred to the Adult Headache Centre of the University of Palermo (A.H. Study) between 2007 and 2009, and 316 controls without headache (each patient was matched by sex and age to four controls).The head…
Cluster headache in relation to different age groups
Cluster headache (CH) has always been considered a type of primary headache affecting predominantly male subjects in early and medium adulthood. However, recent studies carried out in large case series of patients with CH show that not infrequently it may set in also after age 50; by contrast, onset before adolescence is very rare. Additionally, when onset occurs before age 14 or from the sixth decade of life onward, male predominance decreases to the point that in chronic forms CH predominantly affects the female sex. This particular pattern of the gender ratio in relation to onset in different age groups suggests that hormonal factors may actually play a role in the genesis of CH. In part…
Age of onset of episodic and chronic cluster headache – a review of a large case series from a single headache centre
Background In the largest case series of cluster headache (CH) published in the literature, age of onset varies between 29.6 and 31.6 years. Differences in onset age based on gender and subtype diagnosis are reported, while there are only few data on patients with childhood and elderly onset. We therefore deemed it useful to review our own large case series of CH patients. Methods The age of onset of cluster headache was investigated in a consecutive case series of 808 patients (585 men and 223 women), including 686 (503 men and 183 women) with episodic cluster headache (ECH), 103 (66 men and 37 women) with chronic cluster headache (CCH), and 19 with an indeterminate form of CH (16 men and …
Anxiety disorder, depression and chronic daily headache: a case-control study.
Chronic headache cause high disability in sufferers and high social cost. Data regarding possible comorbid diseases, manly depression and anxiety, are still few and conflicting.The aim of this case-control, hospital-based study was: to evaluate the prevalence of depression and anxiety in subjects with chronic migraine (CM) and chronic tension-type headache (CTTH); and to compare the results with those found in a control group without headache. Materials and methods We studied 79 patients, 46 with CM and 33 with CTTH, consecutively referred to the Adult Headache Centre of the University of Palermo (A.H. Study) between 2007 and 2009, and 316 controls without headache (each patient was matched…
The PACE study: Past-year prevalence of migraine in Parma's adult general population
Background: In the literature there are few data about the prevalence of primary headaches, including migraine, in the Italian general population. The PACE study (PArma CEfalea, or ‘Headache in Parma’) is an observational study aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma’s adult general population. Materials and methods: A total of 904 subjects representative of Parma’s adult general population were interviewed face-to-face by a physician from the Parma Headache Centre. They were given a specially designed and validated questionnaire for the diagnosis of primary headaches according to the ICHD-II criteria. Results: Past-year adjusted pr…