Comparing Migraine Headache Index vs. Monthly Migraine Days Following Nerve Deactivation for Headache: A Systematic Review and Meta-Analysis.

Abstract

Nerve deactivation surgery for the treatment of migraine has quickly evolved over the last two decades. Studies typically report changes in migraine frequency (attacks/month), attack duration, attack intensity, and their composite score, the migraine headache index (MHI), as primary outcomes. However, the neurology literature predominantly reports migraine prophylaxis outcomes as change in monthly migraine days (MMD). Therefore, the goal of this study is to foster common communication between plastic surgeons and neurologists by assessing the effect of nerve deactivation surgery on monthly migraine days (MMD) and motivating future studies to include MMD in their reported outcomes. An updated literature search was performed according to the PRISMA guidelines. The National Library of Medicine (PubMed), Scopus, and EMBASE were systematically searched for relevant articles. Data was extracted and analyzed from studies which met the inclusion criteria. A total of 19 studies were included. There was a significant overall reduction in monthly migraine days (mean difference [MD] 14.11, 95% CI 10.95 to 17.27; I2 = 92%), total migraine attacks per month (MD 8.65, 95% CI 7.84 to 9.46, I2 = 90%), migraine headache index (MD 76.59, 95% CI 60.85 to 92.32; I2 = 98%), migraine attack intensity (MD 3.84, 95% CI 3.35 to 4.33; I2 = 98%), and migraine attack duration (MD 11.80, 95% CI 6.44 to 17.16; I2 = 99%) at follow-up (range 6-38 months). This study demonstrates the efficacy of nerve deactivation surgery on the outcomes used in both the PRS and neurology literature.