Headache

Chronic Migraine

Chronic migraine refers to migraine headaches occurring at least 15 days per month, frequently associated with significant functional impairment and depression.

Outcomes of Treatment in Chronic Migraine Patients (N = 73)

2023

GAD-7 = Generalized Anxiety Disorder Questionnaire, HIT-6 = Headache Impact Test, PHQ-9 = Patient Health Questionnaire, PROMIS = Patient Reported Outcome Measurement Information System.

In 2023, 73 patients with chronic migraine completed at least 1 questionnaire following treatment. Of the 15 patients who reported HIT-6 scores > 50 at initial evaluation (higher scores indicate greater impairment secondary to headache pain¹), 46.7% reported improvement. The PROMIS is a self-reported measure of physical and emotional health status reflecting health-related quality of life.² Of the 38 patients who reported initial PROMIS global health more than one-half standard deviation below the normative mean, 78% improved or remained stable. Of the 35 patients who reported initial depressive symptoms above the cutoff of ≥ 10 points for the PHQ-9 (higher scores indicate greater depression³), 25.7% remained improved at six months follow-up. Of the 28 patients who reported initial anxiety symptoms above the cutoff of ≥ 10 points for the GAD-7,⁴ 17.9% reported improvement at follow-up.

References
  1. Coeytaux RR, Kaufman JS, Chao R, Mann JD, Devellis RF. Four methods of estimating the minimal important difference score were compared to establish a clinically significant change in Headache Impact Test. J Clin Epidemiol. 2006 Apr;59(4):374-380.
  2. Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009 Sep;18(7):873-880.
  3. Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Med Care. 2004 Dec;42(12):1194-1201.
  4. Toussaint A, Hüsing P, Gumz A, Wingenfeld K, Harter M, Löwe B. Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7). J Affect Disord. 2020 Mar 15;265:395-401.