Investigation of the risk factors for the transition of episodic migraines to chronic migraines

Abstract

Chronic migraine (CM) is a frequent complication of migraines that has a serious impact on personal and social life and is still underdiagnosed. The aim of this study was to determine risk factors for the progression to CM and to investigate the relationship of these factors to the disease prognosis. In all, 115 CM and 377 episodic migraine patients from between February 2015 and December 2017 were enrolled. The age of disease onset, headache duration and frequency, presence of aura and type of aura, clinical properties and location of headache, pain severity, trigger factors, presence of family history, visual analogue scale (VAS) and Allodynia Symptom Checklist (ASC) scores, presence of allodynia, and Migraine Disability Assessment (MIDAS) scores were recorded and the 2 groups were compared statistically. Logistic regression was used to determine the independent risk factors for a conversion to CM. The mean age of the 492 patients (408 female, 84 male) was 36.03±12.67 years, the disease duration was 10.78±10.36 years, the attack frequency was 10.35±9.06 attacks/month, and the attack duration was 30.10±23.54 hours. There were 115 patients (104 female, 11 male) with CM. Female gender (p=0.015), attack frequency (p<0.001), ASC score (p=0.002), VAS score (p=0.001), and MIDAS score (p<0.001) had greater representation in the CM group. Medication overuse (relative risk [RR]: 0.9) and allodynia (RR: 0.3) were independent risk factors for a transition to CM in the logistic regression analysis (p<0.05). Based on the present data of a tertiary headache center, it was concluded that CM is a disabling neurological disease with a serious personal and public burden. Special care should be taken among patients with medication overuse and cutaneous allodynia with regard to the possibility of transition to CM.