Interictal Daily Functioning in Migraine

Abstract

Migraine induces disability and an impaired quality of life, even between attacks. As most studies are based on subjective reports only, this study was set up to objectively quantify the interictal daily activities and heart rate of migraine patients, in relation to their subjectively reported highest realizable level of activity and of symptoms of mood in their habitual environment. Measurements were obtained during a migraine-free 2-day period of 24 patients (age range: 21-57 years) and 24 controls (age range: 18-59 years). Accelerometry was used to quantify the time spent in different postures and movements. The subjective parameters were documented by daily log. Whereas heart rate was similar for patients and controls, migraineurs were found to be significantly less physically active than controls and reported a significantly lower realizable level of activity. In addition, when active, their body motility was less than that of controls. Migraine patients also showed a higher level of sleepiness and lower level of vigour. These interictal behavioural and subjective phenomena objectively illustrate the individual and societal burden of migraine and its chronic impact on both domains.

EuroQol (EQ-5D) health utility scores for patients with migraine

“…This between-attack patient burden can reflect anxiety in anticipation of the next painful attack and concern over the potential impact on future plans and activities [24]. There may also be reduced quality of life between attacks related to more general feelings of anxiety, depression, irritability, and sleepiness, which have been observed with greater frequency among migraineurs than corresponding population controls [24][25][26][27] However, the degree to which one or more of these health effects are the result of migraine itself, side effects of medication use (e.g., sleepiness), or independent conditions resulting from some shared risk factor for migraine is not fully understood. Randomized, double-blind, placebo-controlled clinical trials of prophylactic migraine treatments exhibiting efficacy in reducing headache days have produce mixed results, with several studies showing a statistically significant benefit on some quality of life indices [28][29][30][31][32] and others failing to do so [33,34].…”

Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls. A systematic review

“…In the study by Stronks et al 26 point estimates were missing. Table 2 summarizes the methods used to assess physical activities, the results and conclusions of the selected studies, grouped for five different syndromes: chronic fatigue syndrome, mixed pain conditions, low back pain, migraine and fibromyalgia.…”

“…In one study the CV could not be calculated because necessary parameters were missing. 26 In eight of the remaining 11 studies the CV was higher in the patient group than in controls ( Figure 2). The CV of all objective methods used was higher in the patient groups than in controls.…”

One-day acceptance and commitment training workshops in medical populations

“…They also exhibit more avoidance behaviors than healthy controls. Moreover, those with lower levels of acceptance report more pain-related interference and disengagement from activities [29, 30]. In a 1-day intervention by Dindo et al, 45 patients with comorbid depression and migraine were assigned to 5-hour ACT combined with a 1-hour Migraine Education workshop (ACT-ED; n=31) or to TAU (n=14) [31, 32].…”