Abstract
The aim of the work is to study the occurrence of psycho-emotional and autonomic disturbance and the impact of headache on the daily activities of patients with episodic migraine, depending on the presence of concomitant cervicalgia. Materials and methods: 77 patients with episodic migraine (17 with aura, 60 without aura, 28 men and 84 women, 18-58 years, mean 42.5±15.5 years) were included. 42 of them had concomitant cervicalgia. All patients were divided into 2 groups: I – episodic migraine with concomitant cervicalgia, II – episodic migraine without neck pain. The Spilberg-Hanin's anxiety scale, the Beck depression scale, Wayne questionnaire, Neck Disability Index and the MIDAS were used. Results. The number of psycho-emotional disorders was higher in group patients with combined episodic migraine and cervicalgia (p<0.05). The indicators of autonomic disturbance were also higher in I group (p<0.05). The indicators depression correlated with autonomic status on subjective signs symptoms of (r=0.380) and objective signs (r=0.554). In I group the autonomic disturbance on subjective signs correlated with state anxiety (r=0.312), trait anxiety (r=0.348) and Beck scale (r=0.351). In group II autonomic objective signs correlated with the patient’s self-assessment on the same scale (r=0.919). The level of neck disability on NDI correlated with autonomic dysfunction on objective signs (r=0.338) in I group. The decrease of daily activity was more significantly reduce on MIDAS in I group compare with II group. Conclusion. The combination of episodic migraine and cervicalgia in patients significantly reduces the daily activity rate on the MIDAS. The concomitant cervicalgia in patients with episodic migraine to contribute increase rates of state and trait anxiety and mild depressive symptoms and autonomic disturbance
Highlights
The migraine is the most common neurological disease, which is often accompanied by comorbidities and concomitant diseases, which increases the overall burden on migraine patients, reduces quality of life and adds economic costs
When analyzing the effect of migraine on daily activity on the MIDAS scale, it was found that patients with a combination of migraine and cervicalgia had a statistically significantly greater impact compared with episodic migraine without cervicalgia (p=0.0049), in this group there were more missed training or workdays (p=0.0225) and the number of days on which they did not do household chores due to headache (p=0.0116)
The predominance in group I of depressive disorders can be explained by chronic pain syndrome, which is caused by myofascial dysfunction of the neck muscles
Summary
The migraine is the most common neurological disease, which is often accompanied by comorbidities and concomitant diseases, which increases the overall burden on migraine patients, reduces quality of life and adds economic costs. Most of them were identified as risk factors for the progression of episodic migraine [1]. Combination of comorbidities or “multimorbidity” is associated with the risk of chronic migraine [2, 3]. Depressive disorders and anxiety are the most common among migraine patients [4, 5]. The high comorbidity of migraine and chronic pain (up to 39.5 %) indicates a pathogenetic link between migraine and pain disorders [6]. There is a high frequency of myofascial pain syndrome of craniocervical localization in patients with verified migraine. Myofascial dysfunction of temporal, masticatory, occipital muscles, muscles of a back surface of a neck and muscles of upper arms is registered [7, 8]
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