A Cross-Sectional Analysis of Migraine-Related Disability in CADASIL

Gender-based discrimination and its influence on mental health symptoms among people living with and without migraine: A case-control study

Women are more likely than men to experience migraine and to endorse worse symptoms. Migraine is associated with anxiety, depressive and posttraumatic stress disorders. Women who experience migraine are also more likely to report a history of discriminatory experiences. This study investigated migraine characteristics, mental health outcomes and gender-based discrimination among women using a case-control study with a migraine and non-migraine sample. Two hundred ninety-two women completed an online survey with measures of migraine characteristics (as applicable), mental health symptoms, and gender-based discrimination. Women living with migraine experienced worse mental health symptoms and more gender-based discrimination than the non-migraine group. Migraine frequency and lifetime day-to-day discrimination significantly predicted anxiety, depression, and trauma symptoms, while anticipated discrimination significantly predicted trauma symptoms; lifetime day-to-day discrimination significantly predicted migraine-related reduction in productivity; and gender-based discrimination significantly predicted migraine-related social absences. These findings may be used to improve management of migraine among women.

Management of Inherited CNS Small Vessel Diseases: The CADASIL Example: A Scientific Statement From the American Heart Association

Lacunar infarcts and vascular dementia are important phenotypic characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, the most common inherited cerebral small vessel disease. Individuals with the disease show variability in the nature and onset of symptoms and rates of progression, which are only partially explained by differences in pathogenic mutations in the NOTCH3 gene. Recognizing the disease early in its course and securing a molecular diagnosis are important clinical goals, despite the lack of proven disease-modifying treatments. The purposes of this scientific statement are to review the clinical, genetic, and imaging aspects of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, contrasting it with other inherited small vessel diseases, and to provide key prevention, management, and therapeutic considerations with the intent of reducing practice variability and encouraging production of high-quality evidence to support future treatment recommendations.

Prevalence and impact of migraine among university students in Bangladesh: findings from a cross-sectional survey

Background

Migraine is one of the main causes of long-term morbidity, and it is one of the major contributors of all types of headaches in worldwide. Despite its disruptive effect, it is frequently underdiagnosed and undertreated in Bangladesh. The aim of the present study was to determine the prevalence of migraines and its impact on daily life of university students in Bangladesh.

Methods

This cross-sectional study was conducted among 2,352 students of Rajshahi University and Jahangirnagar University during March 2020 through a self-administered online survey. ID Migraine™ scale and HIT-6 scale were used to screen migraine and its impact respectively. Frequency distribution, Chi-square test and t-test along with multiple logistic regressions model were used to determine the prevalence and associated factors of migraine respectively.

Results

The overall prevalence of migraine among the participants was 21.4%. The prevalence was higher among females (29%) than males (12%). A multivariable logistic regression model provided the following eight risk factors of migraine: (i) gender (p < 0.01), (ii) family income (p < 0.01), (iii) marital status (p < 0.01), (iv) infrequent exercise (p < 0.01), (v) family history of headache (p < 0.01), (vi) high screen time (p < 0.05), (vii) depressive symptoms (p < 0.05) and (viii) anxiety disorder (p < 0.01). More than two-thirds of the people with migraines reported more than five attacks during the past month with moderate to severe intense headache. Stress was the most reported trigger of migraine among university students (71%) followed by irregular sleep (47%), academic pressure (33%), and external noise (28%). Almost 37% of the participants who had migraines reported that headache caused severe impact in their day to day life.

Conclusions

The prevalence of migraine among university students of Bangladesh is alarmingly high. Frequent migraine attacks and severe intensity of headache cause a substantial level of impact among the sufferers. Cautious avoidance of the triggering factors through appropriate interventions and prophylactic medication can mitigate the negative impact of migraine as well as improve the quality of life.