Objective To investigate the influencing factors of moderate to severe disability in migraine patients. Methods Patients diagnosed with migraine between September 2022 and January 2024 in the outpatient service or inpatient Department of Neurology of Baotou Central Hospital and Baotou Eighth Hospital were included. According to the scores of the Migraine Disability Assessment questionnaire, patients were divided into a group with no or mild disabilities and a group with moderate to severe disabilities. The sociodemographic, disease characteristics, and scale datas of two groups of patients were collected, and a multivariate logistic regression model was used to explore the influencing factors of moderate to severe disability in migraine patients. Results A total of 116 patients were included. Among them, there were 49 cases in the group with no or mild disabilities, and 67 cases in the group with moderate to severe disabilities. There were statistically significant differences in gender, duration of headache, severity of headache, number of headache days per month, drug overuse, the scores of Generalized Anxiety Disorder-7 scale, the scores of Patient Health Questionnaire-9 scale, the scores of Pittsburgh Sleep Quality Index scale, the scores of Headache Impact Test scale, the scores of Montreal Cognitive Assessment scale, and the scores of 36-item Short-Form Health Survey questionnaires between the two groups (P<0.05). There was no statistically significant difference in other sociodemographic information and disease characteristics between the two groups of patients (P>0.05). The results of multivariate logistic regression analysis showed that the number of headache days per month, the scores of Generalized Anxiety Disorder-7 scale, the scores of Headache Impact Test scale, and the scores of 36-item Short-Form Health Survey questionnaire were independent influencing factors for moderate to severe disability in migraine patients (P<0.05). Conclusions Headache duration, anxiety disorders and health-related quality of life are influencing factors for moderate to severe disability in migraine patients. Early screening and intervention of influencing factors for migraine patients should be emphasized.
Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
To overview the methodology and procedure used in developing evidence-based guidelines for migraine headache, the article described the two procedures systematically: 1. the Methods used in the Agency for Health Care Policy and Research’s Technical Reviews. 2. US Headache Consortium’s Methods used in developing clinical guidelines
ObjectiveTo evaluate the efficacy and safety of traditinal Chinese Medicine (TCM) syndrome classification and intervention for the prophylaxis of menstrual migraine. MethodsPatients consistent with the inclusion criteria from January 2013 to June 2014 were included in the trial. Patients were randomized by their visiting order into two groups:the experimental group was treated with Chinese traditional medicine compound decoctions (two doses for three days), and the control group was treated with vitamin B2 (400 mg once daily). The patients were treated for thirty days consecutively. Efficacy was assessed using the records of the frequency, duration, and severity of migraine attacks. Laboratory tests, vital signs, and adverse events were monitored. ResultsBoth treatments led to a significant reduction in the frequency, duration, and severity of migraine attacks (P<0.05). TCM therapy was significantly better than vitamin B2 for reducing the frequency and the duration of migraine (P<0.05). No serious adverse drug reaction was found in both groups. ConclusionTCM syndrome classification and intervention is effective and relatively safe in the prophylaxis of menstrual migraine attacks.
ObjectiveTo systematically review the association between migraine and lacunar infarcts on MR image.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials, cohort studies and cross-sectional studies on the association between migraine and lacunar infarcts from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 studies involving 5 104 participants were included. The results of meta-analysis showed that: there were no significant associations of migraine (OR=0.93, 95%CI 0.78 to 1.12, P=0.470) and aura (OR=1.10, 95%CI 0.89 to 1.36, P=0.390) with lacunar infarcts on MR image. Subgroup analysis by age, presence or absence of aura showed no significant tendency.ConclusionsThere is no significant relationship between migraine and lacunar infarcts. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objectives We aimed to assess the methodological qual ity of RCT on acupuncture for migraine prophylaxis. Methods With the searching terms including acupuncture, migraine, prophylaxis and prevent, etc, the database of the Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMBase (1966-2007), CBM (1978-2007) and CMCC (1994-2007) were searched from their date of start publ ication. Chinese medical journals and relevant academic conference proceedings were hand searched as well. Several items in included trials were assessed, including methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures and follow-up, etc. Result Among the 12 included trials, 9 trials overseas were high-qual ity and 3 in China were low-quality. Frequency or days of migraine attacks and SF-36/SF-12 were often evaluated as outcome measures in western countries, while headache index was used in China. Among the 12 trials, 9 reported the follow-up outcomes and 8 mentioned adverse events. Conclusion There was no high qual ity trial on acupuncture for migraine prophylaxis in China. The outcome measures in trials published in China by now can not evaluate the outcomes of acupuncture for migraine prophylaxis accurately. To study designs, advantages of trials oversea can be used for reference. To Chinese cl inical physicians, prophylactic therapy and abortive therapy of migraine should be distinguished in order to design high-qual ity study on acupuncture for migraine prophylaxis.
Objective To improve care and outcomes for all migraine suffers, the USHC created these evidence-based guidelines for migraine headache. Methods Firstly, 5 relative Technical reviews were done according to the Methods used in the AHCPR Technical Reviews. Secondly, based on the results of the 5 technical reviews, the 4 treatment guidelines were developed in direction of the USHC’S Methods used in developing clinical guidelines. Results Evidence supporting the acute treatment and preventive treatment were exclusively Class 1 studies, evidence supporting the diagnostic testing were either Class 2 or Class 3 studies , only very few expert judgment was given on some compelling issues without evidence. The recommendations they supporting were high-qualified, middle-qualified, and poor-qualified respectively. Conclusion This Evidence-Based Guidelines is one of the first and most extensive cooperative projects available for creating guidelines. The guideline was developed with systematical and scientific methods and stroven to base all of its recommendations on evidence.
Objective To evaluate the efficacy of Yangxue Qingnao Grain for migraine. Methods We searched The Cochrane Library (Issue 3, 2007), EMBASE (1974 to June 2007), PubMed (1966 to June 2007), VIP (1989 to June 2007), CNKI (1979 to June 2007) and CBM (1978 to June 2007) to identify randomized controlled trials or quasirandomized controlled trials comparing Yangxue Qingnao Grain versus sibeline for migraine. The quality of included studies was critically assessed and data analyses were performed with The Cochrane Collaboration’s RevMan 4.2.7. Results Eight studies were included, involving 5 randomized trials and 3 quasi-randomized trials. Meta-analyses showed that the total response rate (RR=1.07, 95%CI 1.00 to 1.15, P=0.06), the duration of headache (WMD 1.33, 95%CI – 0.87 to 3.52, P=0.24), and the frequency of headache episodes (WMD 0.93, 95%CI –1.00 to 2.86, P=0.35) were similar between Yangxue Qingnao Grain and sibeline. One study reported that the changes of ACA (WMD 3.70, 95%CI –3.46 to 10.86), MCA (WMD 0.60, 95%CI –10.37 to 11.57), ICA (WMD 3.40, 95%CI –4.35 to 11.15) and DCA (WMD – 2.30, 95%CI –9.52 to 4.92) revealed by transcranial doppler sonography were also comparable between the two groups. Conclusion Yangxue Qingnao Grain is effective in the treatment of migraine, but its superiority over sibeline is not demonstrated. Due to the poor quality and small sample of the included trials, more large-scale multi-center randomized trials are needed.
ObjectivesTo systematically review the efficacy of acupuncture for improving migraine symptoms and cerebral blood flow velocity.MethodsCBM, CNKI, VIP, WanFang Data, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on acupuncture for improving migraine symptoms and cerebral blood flow velocity from inception to September, 2017. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 RCTs involving 2 226 patients were included. The results of meta-analysis showed that, acupuncture could effectively reduce the frequency of migraine compared with placebo acupuncture (SMD=−0.97, 95%CI −1.60 to −0.34, P=0.002) and medicine group (SMD=−1.29, 95%CI −1.85 to −0.73, P<0.000 01). Acupuncture could shorten duration of headache compared with placebo acupuncture (SMD=−0.73, 95%CI −1.25 to −0.21, P=0.006) and medicine group (SMD=−0.88, 95%CI −1.32 to −0.45, P<0.000 1). Compared with placebo acupuncture, acupuncture could relieve headache intensity (SMD=−0.67, 95%CI −1.15 to −0.19, P=0.006). The acupuncture group was superior to the placebo acupuncture group (SMD=−10.99, 95%CI −16.62 to −5.36, P=0.000 1) and medicine group (SMD=−0.63, 95%CI −0.87 to −0.40, P<0.000 01) in improving the cerebral blood flow velocity.ConclusionsCurrent evidence shows that acupuncture can effectively reduce frequency of migraine, shorten duration of migraine, relieve intensity of migraine and improve cerebral blood flow velocity. Due to limited quality of the included studies, more high quality studies are required to verify above conclusion.