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Determinants of the severity of comorbid migraine in multiple sclerosis

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Abstract

A high co-morbidity between multiple sclerosis (MS) and migraine has been reported, especially in young female patients affected by a relapsing-remitting (RR) course of MS. In this study, we aimed to elucidate the determinants of the severity of comorbid migraine in MS. Demographic, clinical and psychometric variables were collected from a cohort of 205 RR-MS patients regularly attending to an Italian outpatient MS Centre. Of them, 102 (49.8 %) were diagnosed as affected by comorbid migraine. About one-third of MS patients with comorbid migraine have asked the attending neurologist a specific anti-migraine treatment. Despite this, only few MS patients (10.8 %) reported a prior use of prophylactic drugs, and even fewer (2.9 %) took triptans as pain killers; these proportions were significantly lower when compared with those of a control group of 63 migraineurs subjects without MS (p < 0.0001 for both comparison). Factors associated with a moderate or severe disability (MIDAS grades III or IV) due to comorbid migraine in MS patients were the depressive state (OR = 4.294; p = 0.001), the anxiety trait (OR = 5.786; p = 0.004) and an ongoing IFNB treatment (OR = 2.337; p = 0.028). Likewise, depression (OR = 3.453; p = 0.048) and anxiety (OR = 4.582; p = 0.014) were both independent predictors for having a MIDAS grades of III or IV also in migraineurs subjects without MS. Investigating the determinants of migraine severity may allow a better management of MS patients with comorbid migraine. In these patients, a tailored therapeutic approach is warranted to improve their quality of life and reduce the burden of these two chronic and disabling conditions.

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Acknowledgments

This research was carried out using information collected during normal patient care, and extra time spent in data analysis and interpretation was part of educational programmes within the University (V.V., L.P., L.D.G.); no external source of funding was required.

Conflict of interest

Prof. Pozzilli has received honoraria for consultancy or speaking from Sanofi-Aventis, Biogen Idec, Bayer Schering, Merck Serono, and Novartis and has received research grants from Sanofi-Aventis, Merck Serono, and Bayer Schering. Prof. Salvetti has received research grants from Sanofi-Aventis, Merck Serono, and Bayer Schering, and lecture fees from Biogen Idec. Dr. Prosperini has received honoraria for consultancy from Merck Serono and lecture fees from Biogen Idec. Drs. Villani, De Giglio, Sette do not have any disclosures to report.

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Authors and Affiliations

  1. Neurological Headache Centre, S. Andrea Hospital, Sapienza University, Via di Grottarossa, 1035-00189, Rome, Italy

    Veronica Villani & Giuliano Sette

  2. Department of Neurology and Psychiatry, Sapienza University, Rome, Italy

    Veronica Villani, Carlo Pozzilli & Luca Prosperini

  3. Department of Psychology, Sapienza University, Rome, Italy

    Laura De Giglio

  4. Centre for Experimental Neurological Therapies (CENTERS), S. Andrea Hospital, Rome, Italy

    Marco Salvetti

Authors
  1. Veronica Villani
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  2. Laura De Giglio
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  4. Carlo Pozzilli
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  5. Marco Salvetti
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  6. Luca Prosperini
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Correspondence to Veronica Villani.

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Villani, V., De Giglio, L., Sette, G. et al. Determinants of the severity of comorbid migraine in multiple sclerosis. Neurol Sci 33, 1345–1353 (2012). https://doi.org/10.1007/s10072-012-1119-5

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  • DOI: https://doi.org/10.1007/s10072-012-1119-5

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