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Hrytsenko O, Kopchak O, Kozyk M, Strubchevska K. The impact of the COVID-19 pandemic on patients with migraine. SAGE Open Med 2023; 11:20503121231170726. [PMID: 37143608 PMCID: PMC10151915 DOI: 10.1177/20503121231170726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023] Open
Abstract
Objectives The aim of our work was to assess the impact of the COVID-19 pandemic and quarantine measures on migraine patients in regards to the activity of the disease, the psycho-emotional background of the patients and their quality of life. Methods his study included 133 patients with established diagnosis of migraine. All study participants were divided into two clinical groups: A-patients with chronic and episodic forms of migraine, who had a history of positive PCR test for COVID-19, and B-patients with chronic and episodic forms of migraine who did not have a history of coronavirus disease. Results We detected increase in the number of antimigraine medication (p = 0.04), frequency of headache attacks (p = 0.01), and the psycho-emotional state deterioration (increase in the Hamilton anxiety scale score) (p = 0.002) in patients after recovery from the coronavirus disease. There was no significant difference in the headache's intensity according to the VAS scale (p = 0.51) as well as in the dynamics of the Beck depression scale score (p = 0.09) before and after the COVID-19 infection. Conclusion Patients with a history of migraine who recovered from COVID-19 showed increased frequency of migraine headache attacks and anxiety.
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Affiliation(s)
- Olena Hrytsenko
- Department of Neurology, Psychiatry and
Physical Rehabilitation, Private Higher Educational Establishment “Kyiv Medical
University”, Kyiv, Ukraine
- Olena Hrytsenko, Department of Neurology,
Psychiatry and Physical Rehabilitation, Private Higher Educational Establishment
“Kyiv Medical University”, 2, Boryspilska Street, Kyiv 02099, Ukraine.
| | - Oksana Kopchak
- Department of Neurology, Psychiatry and
Physical Rehabilitation, Private Higher Educational Establishment “Kyiv Medical
University”, Kyiv, Ukraine
| | - Marko Kozyk
- Internal Medicine Resident, Corewell
Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Kateryna Strubchevska
- Internal Medicine Resident, Corewell
Health William Beaumont University Hospital, Royal Oak, MI, USA
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Aleyeidi NA, Alqahtani RS, Alotaibi HF, Alotaibi AH, Alotaibi KM, Alnofiey RM. Exploring the Impact of the COVID-19 Quarantine on the Severity of Headache, Migraine, and Stress in Saudi Arabia. J Pain Res 2021; 14:3827-3835. [PMID: 34934356 PMCID: PMC8684435 DOI: 10.2147/jpr.s332886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/14/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose This cross-sectional study aimed to investigate the impact of COVID-19 quarantine on the severity of migraine symptoms and stress among adults in Saudi Arabia. Patients and Methods Between December 2020 and February 2021, 1212 participants aged 18–65 years completed an online self-administered questionnaire that covered sociodemographic data, self-administered questions, the ID migraine screener, numeric pain rating scale, and the perceived stress scale. Statistical analyses were performed using SPSS. Student’s t-test, paired t-test, and analysis of variance were used to compare quantitative variables, while the chi-square test was used to compare qualitative variables. Results After removing ineligible and incomplete responses, we analyzed data obtained from 1111 participants. The mean age of the participants was approximately 29 years old (± 11.2 years); moreover, 87% were females. Headache severity during the COVID-19 quarantine was significantly lower than that during the last 3 months, with a difference of only 0.41 on the 1–10 pain severity scale. There was a significantly increased stress prevalence during the COVID-19 quarantine. During the COVID-19 quarantine, 49%, 56%, and 62% of patients without migraine, patients with possible migraine, and patients with diagnosed migraine, respectively, reported worsening of their perceived stress. There was a weak positive correlation between the severity of migraine symptoms and stress during COVID-19 quarantine. Moreover, headache severity was positively affected by the history of COVID-19 infections. Conclusion The headache severity in patients with migraine decreased during COVID-19 quarantine compared with that during the last 3 months. Additionally, patients with diagnosed migraine had significantly higher scores on the perceived stress scale than patients without migraine.
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Affiliation(s)
- Nouran A Aleyeidi
- Department of Clinical Sciences, Community Medicine Course, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Raneem S Alqahtani
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hawazin F Alotaibi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Amjad H Alotaibi
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Abstract
Dietary triggers are commonly reported by patients with a variety of headaches, particularly those with migraines. The presence of any specific dietary trigger in migraine patients varies from 10 to 64 % depending on study population and methodology. Some foods trigger headache within an hour while others develop within 12 h post ingestion. Alcohol (especially red wine and beer), chocolate, caffeine, dairy products such as aged cheese, food preservatives with nitrates and nitrites, monosodium glutamate (MSG), and artificial sweeteners such as aspartame have all been studied as migraine triggers in the past. This review focuses the evidence linking these compounds to headache and examines the prevalence of these triggers from prior population-based studies. Recent literature surrounding headache related to fasting and weight loss as well as elimination diets based on serum food antibody testing will also be summarized to help physicians recommend low-risk, non-pharmacological adjunctive therapies for patients with debilitating headaches.
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Affiliation(s)
- Zoya Zaeem
- Division of Neurology, University of British Columbia, 8219-2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Lily Zhou
- Division of Neurology, University of British Columbia, 8219-2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Esma Dilli
- Division of Neurology, University of British Columbia, 8219-2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
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Kubik SU, Martin PR. The Headache Triggers Sensitivity and Avoidance Questionnaire: Establishing the Psychometric Properties of the Questionnaire. Headache 2016; 57:236-254. [PMID: 27753075 DOI: 10.1111/head.12940] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the psychometric properties of the newly developed Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) designed to measure variables relating to the Trigger Avoidance Model of Headaches. BACKGROUND The Trigger Avoidance Model of Headaches proposes that one pathway to developing a primary headache disorder is through the avoidance of headache triggers, resulting in an increase in trigger potency through sensitization. Conversely, prolonged exposure to certain triggers may reduce a potential trigger's ability to precipitate a headache. This model has led to an alternative approach to trigger management being proposed called Learning to Cope with Triggers, which advocates the desensitization of certain headache triggers through controlled exposure, while supporting avoidance of those triggers that are detrimental to health and wellbeing. To be able to evaluate predictions based on the Trigger Avoidance Model of Headaches and to investigate the effectiveness of Learning to Cope with Triggers, psychometrically sound measures of trigger sensitivity and trigger avoidance are needed. METHOD A convenience sample of 376 participants (87.5% female; 64.1% European descent) was recruited for the online study which consisted of a battery of measures including the HTSAQ, Brief Headache Screen, Pain Anxiety Symptoms Scale, Pain Sensitivity Questionnaire, Chronic Pain Acceptance Questionnaire, and demographic items. With an interval of 2-6 weeks, a subsample of participants (n = 201) completed the HTSAQ for a second time. The mean age of the sample was 31.4 years (SD = 12.8). The most common headache diagnoses (based on the Brief Headache Screen) were migraine (chronic = 62; episodic = 160), followed by medication-overuse headache (n = 87). The remaining participants (n = 67) were diagnosed as having episodic less severe headache (most likely tension-type headache). RESULTS Reliability was assessed through internal consistency and test-retest reliability over a period of 2-6 weeks, and both were excellent (alpha > .80). Strong construct validity was demonstrated by the measure's scale scores being significantly correlated in theoretically consistent ways with the Pain Sensitivity Questionnaire, Pain Anxiety Symptoms Scale, and Chronic Pain Acceptance Questionnaire. As the Trigger Avoidance Model of Headaches would predict, correlations between the HTSAQ Sensitivity scales and the Avoidance scale were strong (P < .001), and participants with chronic migraine had significantly higher HTSAQ scores than those with episodic headaches. CONCLUSION The findings support the use of the HTSAQ as a valid and reliable tool for assessing sensitivity to headache triggers and avoidance of headache triggers. Further research examining the factor structure of the HTSAQ is warranted.
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Affiliation(s)
- Sonja U Kubik
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paul R Martin
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Martin PR. Stress and Primary Headache: Review of the Research and Clinical Management. Curr Pain Headache Rep 2016; 20:45. [DOI: 10.1007/s11916-016-0576-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Martin PR, Mackenzie S, Bandarian-Balooch S, Brunelli A, Broadley S, Reece J, Goadsby PJ. Enhancing cognitive-behavioural therapy for recurrent headache: design of a randomised controlled trial. BMC Neurol 2014; 14:233. [PMID: 25496514 PMCID: PMC4285632 DOI: 10.1186/s12883-014-0233-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 11/27/2014] [Indexed: 01/03/2023] Open
Abstract
Background We have argued against the traditional approach of counselling avoidance of all triggers of headaches and migraine. Problems with this approach include the impossibility of avoiding all triggers and the high costs associated with trying to do so, and that avoidance could lead to reduced tolerance for the triggers. We have developed an alternative approach called Learning to Cope with Triggers (LCT) that encourages avoidance of triggers that are detrimental to health and wellbeing, but uses exposure to other triggers to desensitise headache sufferers to the triggers. This approach has been shown to be more effective than advising avoidance of all triggers. Trigger management is only one component of a comprehensive treatment program and the current study is designed to evaluate a new approach to treating headaches in which LCT has been integrated into an established cognitive-behavioural therapy (CBT) package (LCT/CBT). Methods/Design A target sample of 120 adult participants who suffer from migraine or tension-type headache, at least six days per month, and have done so for at least 12 months will be recruited. Participants will be randomly assigned to one of three groups: LCT/CBT; Avoid/CBT (CBT combined with instructions to avoid all triggers); and waiting-list control. Measures will include: daily diaries for recording headaches, triggers and medication consumption; headache disability and quality of life; trigger avoidance; locus of control and self-efficacy; and coping strategies. Treatment will involve 12 60-minute sessions scheduled weekly. Assessment will be completed before and after treatment, and at 4 and 12 month follow-up. The data will be analysed to determine which approach is most effective, and predictors of response to treatment. Discussion Migraine and tension-type headache are common and can be disabling. CBT has been demonstrated to be an efficacious treatment for both disorders. However, there is room for improvement. This study aims to increase the efficacy of behavioural approaches and identify factors predictive of a positive response. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12614000435684.
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Affiliation(s)
- Paul R Martin
- School of Applied Psychology and Behavioural Basis of Health, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia.
| | - Sharon Mackenzie
- School of Applied Psychology and Behavioural Basis of Health, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia.
| | - Siavash Bandarian-Balooch
- School of Applied Psychology and Behavioural Basis of Health, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia.
| | - Arissa Brunelli
- School of Applied Psychology and Behavioural Basis of Health, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia.
| | - Simon Broadley
- School of Medicine, Griffith University, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia.
| | - John Reece
- School of Health Sciences, RMIT University, PO Box 71, Bundoora, Victoria, 3083, Australia. .,Australian College of Applied Psychology, Melbourne, Australia.
| | - Peter J Goadsby
- Headache Group, NIHR-Welcome Trust Clinical Research Facility, King's College London, London, UK.
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Behavioral management of the triggers of recurrent headache: A randomized controlled trial. Behav Res Ther 2014; 61:1-11. [DOI: 10.1016/j.brat.2014.07.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 06/23/2014] [Accepted: 07/08/2014] [Indexed: 01/04/2023]
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Martin PR. Behavioral management of migraine headache triggers: learning to cope with triggers. Curr Pain Headache Rep 2010; 14:221-7. [PMID: 20425190 DOI: 10.1007/s11916-010-0112-z] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The literature on migraine triggers is reviewed, including the most common triggers, interactions between triggers, the research evidence related to the capacity of self-reported triggers to precipitate headaches, and the neurobiologic pathways by which triggers induce migraine attacks. An argument is developed against the standard advice to avoid migraine triggers as the best way of preventing attacks, based on conceptual and practical criticisms, and consideration of cognate literatures on chronic pain, stress, and anxiety. A small number of studies suggest that exposure to headache triggers has the same effect as exposure to anxiety-eliciting stimuli, with short exposure associated with increased pain response and prolonged exposure associated with decreased pain response. On the basis of this literature, "learning to cope with triggers" is advocated, where controlled exposure and approach/confront strategies are used to manage migraine triggers, except in cases where such an approach would probably be inappropriate.
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Behavioral management of headache triggers: Avoidance of triggers is an inadequate strategy. Clin Psychol Rev 2009; 29:483-95. [DOI: 10.1016/j.cpr.2009.05.002] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 05/29/2009] [Accepted: 05/30/2009] [Indexed: 01/07/2023]
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