Disability, burden, and symptoms related to sensitization in migraine patients are associated with headache frequency

Background and aims: This observational study assessed the difference in disability, burden, and sensitization between migraine patients with low-frequency headache (LFEM, 1-8 headache days/month), high-frequency headache (HFEM, 9-14 headache days/months), and patients with chronic migraine CM (> 14 headache days/months).

Methods: Migraine patients were subgrouped into three groups according to headache frequency (LFEM, HFEM, CM). Headache-related disability was assessed with the Headache Disability Index questionnaire; neck-related disability was assessed with Neck Disability Index; physical and mental dimensions of quality of life were assessed with Medical Outcomes Study Short Form-36 Physical and Mental; anxiety and depression were assessed with Hospital Anxiety and Depression Scale Anxiety and Depression; symptoms related to sensitization were assessed with Central Sensitization Inventory. Differences among migraine groups were assessed using the Chi-Quadro test, ANOVA, or Kruskal Wallis as appropriate

Results: 197 patients were included (97 LFEM, 68 HFEM, 32 CM). Patients with HFEM and CM differed from patients with LFEM showing a worse headache-related (HFEM, p=0.001; CM, p<0.001) and neck-related disability (HFEM, p=0.009; CM, p=0.003), worse level of physical (HFEM, p=0.001; CM, p=0.001) and mental (HFEM, p=0.001; CM, p<0.001) quality of life, worse level of depression (HFEM, p=0.024; CM, p=0.009), and increase presence of symptoms related to sensitization (HFEM, p=0.003; CM, p<0.001). No differences were found in any variables between patients with HFEM and patients with CM (p> 0.05).

Conclusions: Patients with high-frequency episodic migraine and chronic migraine could be considered in the same segment of the migraine population, with similar degrees of disability and sensitization-related symptoms.