Comparison and predictors of chronic migraine vs. new daily persistent headache presenting with a chronic migraine phenotype

Nagaraj, Karthik; Wei, Diana Y.; Puledda, Francesca; Weng, Hsing-Yu; Waheed, Sadaf; Vandenbussche, Nicolas; Ong, Jonathan; Goadsby, PJ

doi:10.1111/head.14362

Cited by 7 publications

(9 citation statements)

References 27 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Medication overuse occurs in NDPH in an estimated 19% (95% CI 4-33) of children/adolescents and 31% (95% CI 20-42) of adults (see online Supplementary Figure 16). However, it appears to be less common in NDPH than CM – 22% vs. 34% in a childhood comparison study and 33% vs. 51% in an adult comparison study (8,11).…”

Section: Comorbiditiesmentioning

confidence: 87%

“…A paediatric study has compared children with NDPH to those with CM and found that the phenotype was similar, other than a lower prevalence of photophobia in the NDPH group (8). An adult study has compared those with NDPH-CM to those with CM, and found that the NDPH-CM group were less likely to have a family history of headache, had fewer associated migraine symptoms, less osmophobia, nausea and vomiting, and shorter duration of premonitory and postdromal symptoms (11).…”

Section: Phenotype and Classificationmentioning

confidence: 99%

“…Since 2020, several large series of patients with primary NDPH have been published in both children/adolescents and adults, that have included between 155 and 328 patients, respectively (7)(8)(9)(10). Studies have also begun to interrogate its relationship and differentiation from CM and/or CTTH (8,9,11,12). Several studies have also recently been published using functional or structural neuroimaging, which may help to illuminate its pathophysiology (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

New daily persistent headache: A systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

Objective To perform a systematic review and meta-analysis of the epidemiology, precipitants, phenotype, comorbidities, pathophysiology, treatment, and prognosis of primary new daily persistent headache. Methods We searched PubMed/Medline, EMBASE, Cochrane, and clinicaltrials.gov until 31 December 2022. We included original research studies with any design with at least five participants with new daily persistent headache. We assessed risk of bias using National Institutes of Health Quality Assessment Tools. We used random-effects meta-analysis where suitable to calculate pooled estimates of proportions. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis compliant study is registered with PROSPERO (registration number CRD42022383561). Results Forty-six studies met inclusion criteria, predominantly case series, including 2155 patients. In 67% (95% CI 57–77) of cases new daily persistent headache has a chronic migraine phenotype, however new daily persistent headache has been found to be less likely than chronic migraine to be associated with a family history of headache, have fewer associated migrainous symptoms, be less vulnerable to medication overuse, and respond less well to injectable and neuromodulatory treatments. Conclusions New daily persistent headache is a well described, recognisable disorder, which requires further research into its pathophysiology and treatment. There is a lack of high-quality evidence and, until this exists, we recommend continuing to consider new daily persistent headache a distinct disorder.

show abstract

Section: Comorbiditiesmentioning

confidence: 87%

Section: Phenotype and Classificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

New daily persistent headache: A systematic review and meta-analysis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…However, if they feel it is a new distinct entity or their first-ever headache, then in that instance, NDPH should be the diagnosis. The demographics and headache phenotype are somewhat different when comparing chronic migraine to NDPH with a migrainous phenotype (7,73), suggesting that both might be divergent conditions. Treatment responses provide additional clues.…”

Section: Controversy In the Diagnosis And Personal Opinions From The ...mentioning

confidence: 99%

Update in the understanding of new daily persistent headache

Peng

Rozen

2023

Cephalalgia

View full text Add to dashboard Cite

Background Accumulating evidence suggests various specific triggers may lead to new daily persistent headache (NDPH)-like presentations, suggesting that new daily persistent headache is a heterogenous syndrome, and challenging the concept that new daily persistent headache is a primary headache disorder. Method We searched the PubMed database up to August 2022 for keywords including persistent daily headache with both primary and secondary etiologies. We summarized the literature and provided a narrative review of the clinical presentation, diagnostic work-ups, possible pathophysiology, treatment response, and clinical outcomes. Results and conclusion New daily persistent headache is a controversial but clinically important topic. New daily persistent headache is likely not a single entity but a syndrome with different etiologies. The issue with past studies of new daily persistent headache is that patients with different etiologies/subtypes were pooled together. Different studies may investigate distinct subsets of patients, which renders the inter-study comparison, both positive and negative results, difficult. The identification (and removal) of a specific trigger might provide the opportunity for clinical improvement in certain patients, even when the disease has lasted for months or years. Nonetheless, if there is a specific trigger, it remains unknown or unidentified for a great proportion of the patients. We need to continue to study this unique headache population to better understand underlying pathogenesis and, most importantly, to establish effective treatment strategies that hopefully resolve the continuous cycle of pain.

show abstract

“…This heterogenous grouping includes patients diagnosed with ‘primary’ New Daily Persistent Headache or NDPH (formally classified in ICHD-3 as a primary headache disorder) (2) and Persistent Post-Traumatic Headache or PPTH (classified in ICHD-3 as a secondary headache disorder) (2), and various other rarer secondary headache conditions. Overall, these patients represent a minority of cases seen in headache clinics, but they are invariably disabled and the diagnosis is often complicated by the fact that many may display other neurological, predominantly migraine associated symptoms, including nausea, disequilibrium, movement sensitivity, photophobia and phonophobia (3,4). In effect, they very commonly have a migraine phenotype clinically.…”

Section: Introductionmentioning

confidence: 99%

Two-year, real-world erenumab persistence and quality of life data in 82 pooled patients with abrupt onset, unremitting, treatment refractory headache and a migraine phenotype: New daily persistent headache or persistent post-traumatic headache in the majority of cases

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background Patients diagnosed with New Daily Persistent Headache and Persistent Post-Traumatic Headache belong to a heterogeneous group of primary and secondary headache disorders, with the common clinical feature that these conditions start abruptly, continue unabated, and are refractory to conventional migraine preventive treatments. Objective This is a real-world, medium-term audit to explore whether erenumab improves quality of life in a pooled group of 82 abrupt-onset, unremitting and treatment refractory patients, where the diagnosis is new daily persistent headache and persistent post-traumatic headache in the majority of cases. Methods Eighty-two patients were treated with erenumab every 28 days over a two to three-year period, beginning in December 2018. These patients were “longstanding chronic” and refractory with a median of eight (IQR 4–12) prior failed migraine preventive treatments and median duration of disease of seven (IQR 3–11) years. The starting dose of erenumab was 70 mg in 79% of cases and 140 mg in the remaining patients (individuals with a BMI of more than 30). All patients were asked to complete three migraine specific Quality of Life questionnaires or Patient Reported Outcome Measures before starting treatment and typically at 3–12 intervals until the end of June 2021 or cessation of treatment. The Patient Reported Outcome Measures included: Headache Impact Test-6, Migraine Associated Disability Assessment test and Migraine-Specific Quality-of-Life Questionnaire. Patients generally only stayed on treatment after 6–12 months if there was deemed to be an improvement of at least 30% and there were no significant side effects. The longest treated cases have quality of life data for 30 months after starting erenumab. Results Of the 82 patients, 29 (35%) had improvement in Quality of Life scores, with no significant side effects, and wished to stay on treatment. Fifty-three patients (65%) stopped treatment during the first 6–25 months due to lack of efficacy and/or patient reported side effects ( n = 33 and n = 17, respectively) or a combination of both, pregnancy planning ( n = 2), and lost to follow up ( n = 1). Conclusion Significant improvements in Quality of Life scores were recorded by one-third of patients over a period of 11–30 months, with a 35% persistence after a median of 26 months of treatment. This contrasts with our recently published, treatment resistant, chronic migraine cohort where the persistence with erenumab treatment was almost 55% after a median time of 25 months.

show abstract

Comparison and predictors of chronic migraine vs. new daily persistent headache presenting with a chronic migraine phenotype

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 7 publications

References 27 publications

New daily persistent headache: A systematic review and meta-analysis

New daily persistent headache: A systematic review and meta-analysis

Update in the understanding of new daily persistent headache

Two-year, real-world erenumab persistence and quality of life data in 82 pooled patients with abrupt onset, unremitting, treatment refractory headache and a migraine phenotype: New daily persistent headache or persistent post-traumatic headache in the majority of cases

Contact Info

Product

Resources

About