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"Border Zone" Between Episodic And Chronic Migraine Explored In Research By Montefiore Headache Center

Studies Examine Disparities in Sociodemographics, Headache-Related Disability,
Psychiatric, Chronic Pain and Medical Comorbidities
 


NEW YORK (June 26, 2013) – People with high frequency episodic migraine share similar sociodemographic characteristics, headache-related disability and a host of problems like chronic pain, psychiatric comorbidities and medical comorbidities with people who have chronic migraine, according to an analysis of the American Migraine Prevalence and Prevention (AMPP) Study by researchers at the Montefiore Headache Center in the Bronx, N.Y and Vedanta Research in Chapel Hill, NC.


People with high-frequency episodic migraine (HFEM) experience headache 10 to 14 days per month whereas chronic migraine (CM) is defined by migraine with headache on 15 or more days per month. Migraine with fewer than 10 headache days per month is considered low episodic migraine (LFEM). The research will be presented at the International Headache Congress June 27-30 in Boston.


Researchers found respondents with HFEM and CM reported significantly lower household income levels, were less likely to be employed full time and were more likely to be occupationally disabled compared to those with LFEM. Data also showed as headache frequency increased, so did diagnoses of anxiety, depression and bipolar disorder. Rates of chronic pain also increased and were significantly higher in those with HFEM and CM. Additionally, patients with HFEM and CM reported higher rates of cardiovascular and pulmonary diseases, such as asthma, bronchitis, heart disease and stroke, compared to those with LFEM. Significant differences were not seen between those with CM and HFEM on most variables.


“These data suggest a substantial biological overlap between HFEM and CM,” said Richard B. Lipton, M.D., director, Montefiore Headache Center, and professor and vice chair of Neurology, Albert Einstein College of Medicine of Yeshiva University.  “It is apparent, based on these findings, that people living in this “border zone” of high-frequency episodic migraine face a similar burden as those with chronic migraine.  There is a need for additional treatment options to for people with HFEM who in many ways experience similar challenges to those with chronic migraine.”


Researchers analyzed data from 18,500 respondents to the AMPP Study to develop the three studies, entitled “Exploring the Border Zone Between Episodic Migraine and Chronic Migraine.” Analyses included 10,609 respondents with LFEM, 640 with HFEM and 655 with CM.


More than 36 million Americans live with migraine, approximately 4 million of whom have chronic migraine.  Migraine can be extremely disabling and costly, accounting for more than $20 billion in direct (e.g. doctor visits, medications) and indirect (e.g. missed work, lost productivity) costs each year in the U.S.


“These results demonstrate the burden of high-frequency episodic migraine by showing that the condition is as impactful and disabling as CM on many dimensions,” said Dawn C. Buse, Ph.D., associate professor of Clinical Neurology at Einstein, director of behavioral medicine, Montefiore Headache Center and study co-investigator.  “We hope that these findings will prompt scientific discussion around the burden of HFEM and highlight the unmet treatment needs of this group.”