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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Similarities Seen in New Daily Persistent
Headache and Transformed Migraine |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— New daily persistent headache and transformed
migraine appear to have a common underlying pathophysiology, in
contrast to the current diagnostic dictum that distinguishes the
two headache syndromes on the basis of the nature of onset and
the presence of migrainous features, reported Jacqueline E.
Scena on April 17 during the American Academy of Neurology
meeting.
A comparison of matched pairs of patients with new daily
persistent headache and transformed migraine revealed a similar
prevalence of comorbidities and distinct subgroups with more or
fewer migrainous features.
“I think the findings indicate a need to consider the conditions
as part of the migrainous spectrum of diseases and to look at a
broader spectrum of treatment,” said Scena, a medical student at
Jefferson Medical College in Philadelphia. “The most striking
findings were the similarities between the two conditions. Not
only were the prevalence and the comorbidities similar, but
cluster analysis identified the same sorts of subgroups based on
migrainous features. Even the size of the clusters was similar.”
Despite the diagnostic distinctions between new daily persistent
headache and transformed migraine, the two conditions had not
been compared with respect to clinical features and comorbid
disorders, said Scena. To examine similarities and differences
between patients with the two diagnoses, the investigators
evaluated 50 patients with a diagnosis of new daily persistent
headache and 50 age- and gender-matched patients with
transformed migraine.
The patients with new daily persistent headache had more
migrainous features compared with the patients with transformed
migraine (3.4 mean vs. 4.0, P=0.009). However, the two groups
did not differ with respect to the frequency or severity of key
comorbid conditions: depression, irritable bowel syndrome,
fibromyalgia, and restless leg syndrome.
By cluster analysis, Scena and colleagues found that the new
daily persistent headache group and the transformed migraine
group comprised two similar subgroups: one with more comorbid
conditions and one with fewer. The similarity held true for each
of the key comorbid conditions (TABLE). Moreover, the clusters
ranged in size from 20 to 30 patients in each group. |
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