Page 114 - The clinical aspects and management of chronic migraine Judith Anne Pijpers

Chapter 6
Table 1. Baseline characteristics Variable
Female
Age (years) Age at onset
Monthly Migraine days (MMD) Monthly Headache days (MHD)
Days with use of acute anti-headache medicationa Days with use of triptans
Prophylactic treatment b Current use
History of use
Depression, % present (HADS-D ≥ 8)
Anxiety, % present (HADS-A ≥ 8)
Allodynia
(n=129)
110 (85.3%) 44.3 ± 10.5 17.4 ± 9.5
14.9 ± 5.3 21.5 ± 4.7
16.1 ± 5.4 11.1 ± 5.7
50 (38.8%) 115 (89.1%)
51 (39.5%) 50 (38.8%)
No allodynia
(n=44)
22 (50.0%) 47.3 ± 11.2 17.7 ± 9.2
15.9 ± 6.1 21.1 ± 5.0
17.1 ± 6.0 12.0 ± 7.5
13 (29.5%) 43 (97.7%)
15 (34.1%) 5 (11.4%)
P
<0.001
0.120 0.858
0.311 0.661
0.306 0.391
0.273 0.081
0.521
0.001
112
Values are means ± SD or n (%)
a Any anti-headache medication: Simple analgesics (paracetamol, NSAID’s) triptans and/or combination drugs.
b Commonly used prophylaxis for migraine, such as beta-blockers, valproic acid or topiramate.
The absence of cutaneous allodynia was predictive for good outcome after 12 weeks. For the primary endpoint, the odds for reversion from chronic migraine to episodic migraine was 2.5 times higher for participants without allodynia compared to participants with allodynia (OR 2.45; 95%CI 1.03 to 5.84; p=0.042, Table 2 and Fig 2), as 75.0% of participants without allodynia versus 57.4% of participants with allodynia reverted to episodic migraine. The predictive value was more pronounced when allodynia was specified according to spatial distribution, with a 4 and 7 times higher odds for reversion to episodic migraine for participants without allodynia compared to participants with cephalic allodynia and extracephalic allodynia respectively (no allodynia versus cephalic allodynia OR 4.16; 95%CI 1.21 to 14.30; p = 0.003, no allodynia versus extracephalic allodynia OR 7.32; 85%CI 1.98 to 27.11, p = 0.024). When subdivided by type of stimulus, both the combination of mechanical plus thermal allodynia and mechanical allodynia alone were predictive for reversion to episodic migraine, whereas thermal allodynia alone was not predictive (Table 2 and Fig 2).