The migraine postdrome: Clinical characterization, influence of abortive treatment and impact in the quality of life

Inês, Carvalho; Fernandes, Catarina S; Damas, Diogo P; Barros, Francisco; Gomes, Inês R; Gens, Helena MR; Luzeiro, Isabel

doi:10.1016/j.clineuro.2022.107408

Cited by 4 publications

(20 citation statements)

References 20 publications

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“…An overview of the 12 studies is shown in Tables 1 and 2. Eleven were clinic-based (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) and one was population-based (6). Seven studies included only adult participants (6,8,9,12,13,16,17), four enrolled both adult and paediatric participants (7,10,11,14), and one (not included in the meta-analysis) only paediatric participants (15).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Eleven were clinic-based (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) and one was population-based (6). Seven studies included only adult participants (6,8,9,12,13,16,17), four enrolled both adult and paediatric participants (7,10,11,14), and one (not included in the meta-analysis) only paediatric participants (15). Five studies (6,10,13,14,16) provided data on the proportions of participants with one or more postdromal symptoms (the primary outcome measure), but only the four that were clinic-based were included in the meta-analysis (10,13,14,16).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Seven studies included only adult participants (6,8,9,12,13,16,17), four enrolled both adult and paediatric participants (7,10,11,14), and one (not included in the meta-analysis) only paediatric participants (15). Five studies (6,10,13,14,16) provided data on the proportions of participants with one or more postdromal symptoms (the primary outcome measure), but only the four that were clinic-based were included in the meta-analysis (10,13,14,16). Nine studies reported on individual postdromal symptoms (7)(8)(9)(10)(12)(13)(14)16,17), but only eight were eligible for meta-analysis (secondary measures) due to preselected cohorts (i.e.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Five studies (6,10,13,14,16) provided data on the proportions of participants with one or more postdromal symptoms (the primary outcome measure), but only the four that were clinic-based were included in the meta-analysis (10,13,14,16). Nine studies reported on individual postdromal symptoms (7)(8)(9)(10)(12)(13)(14)16,17), but only eight were eligible for meta-analysis (secondary measures) due to preselected cohorts (i.e. experiencing a pre -or postdromal phase was an inclusion criterion) (7,9,10,(12)(13)(14)16,17).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nine studies reported on individual postdromal symptoms (7)(8)(9)(10)(12)(13)(14)16,17), but only eight were eligible for meta-analysis (secondary measures) due to preselected cohorts (i.e. experiencing a pre -or postdromal phase was an inclusion criterion) (7,9,10,(12)(13)(14)16,17). (Figure 2) All 12 studies enrolled participants with migraine with or without aura.…”

Section: Study Characteristicsmentioning

confidence: 99%

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What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies

Christensen,

Eigenbrodt,

Ashina

et al. 2023

Cephalalgia

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Background Postdromal symptoms, following headache resolution, are said to constitute a distinct phase of the migraine attack. We question the evidence for this, with regard both to the nature of such symptoms and to how often they are reported to occur. Methods We searched the Pubmed and Embase databases for relevant articles from their inception until 25 May 2023. We included observational studies recording the proportions of participants with migraine reporting one or more postdromal symptoms or specific individual symptoms. Two reviewers independently screened studies for relevance (agreeing on those to be included), extracted data and assessed risk of bias. Data were analyzed using random-effects meta-analysis to establish the proportions of those with migraine reporting one or more postdromal symptoms, whether among the general population or patients in clinic-based samples. Results Large majorities of participants in either case reported postdromal symptoms: 97% in the only population-based study, and a mean of 86% (95% CI: 71–94%) in four clinic-based studies. The most commonly reported specific symptoms were fatigue (52%; 95% CI: 44–60%), concentration difficulties (35%; 95% CI: 14–65%) and mood changes (29%; 95% CI: 9–64%), none of these being clearly described. These estimates could not be considered reliable: they were subject to substantial study heterogeneity, none of the studies applied International Classification of Headache Disorders definitions of postdromal symptoms, and all had high risk of bias. Conclusion Postdromal symptoms in migraine appear to be very commonly reported, but the data are unreliable with regard both to their nature and to how often they occur. Further studies are needed to conclude that they constitute a distinct phase of migraine.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies

Christensen,

Eigenbrodt,

Ashina

et al. 2023

Cephalalgia

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Approaching headaches and facial pains in eye care practice

Pandey,

Kritika,

Sharma

et al. 2023

Int Ophthalmol

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Postdromal symptoms in migraine: a REFORM study

Thuraiaiyah,

Ashina,

Christensen

et al. 2024

J Headache Pain

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Background Migraine is a multiphasic neurovascular disorder, where headache can be succeeded by postdromal symptoms. However, there are limited research on postdromal symptoms. This study aimed to investigate the proportion of individuals with migraine from a tertiary care unit reporting postdromal symptoms in adherence with the ICHD-3 definition. We also aimed to examine how the means of enquiry might influence the estimated proportions. Additionally, we explored whether any clinical features might affect the likelihood of reporting postdromal symptoms. Finally, we assessed to what extend the postdromal symptoms might impact the disease burden. Methods In a cross-sectional study, we enrolled adult participants diagnosed with migraine who were asked to report their postdromal symptoms (i.e., unprompted reporting). Subsequently, a 16-item list was used to further ascertain the occurrence of postdromal symptoms (i.e., prompted reporting). Clinical characteristics were obtained through a semi-structured interview. Moreover, electronic questionnaires were used to assess the disease burden, i.e., the Six-Item Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS), and the World Health Organization Disability Assessment 2.0 (WHODAS 2.0). Results Among 631 participants with migraine, a higher proportion experienced at least one postdromal symptom when prompted (n = 509 [80.7%]) compared with unprompted reporting (n = 421 [66.7%], P < 0.001). Furthermore, the total number of postdromal symptoms experienced was greater with prompted than unprompted reporting (medians 3 [IQR 1 – 6] versus 1 [IQR 0 – 2]; P < 0.001). Furthermore, the likelihood of reporting postdromal symptoms increased with the presence of premonitory symptoms and decreased with higher number of monthly migraine days. Weak correlations were identified between the number of postdromal symptoms reported and both HIT-6 (ρ = 0.14; P < 0.001) and WHODAS scores (ρ = 0.15; P < 0.001), whilst no correlation was observed with MIDAS score (ρ = 0.08; P = 0.054). Conclusions Postdromal symptoms are prevalent in individuals with migraine from a tertiary care unit. However, reported estimates warrant cautious interpretation as they depend on the means of enquiry, presence of premonitory symptoms, and frequency of monthly migraine days. Moreover, a weak correlation was identified between the number of postdromal symptoms and both HIT-6 and WHODAS scores, indicating only a marginal influence on the disease burden. Graphical Abstract

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The migraine postdrome: Clinical characterization, influence of abortive treatment and impact in the quality of life

Cited by 4 publications

References 20 publications

What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies

What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies

Approaching headaches and facial pains in eye care practice

Postdromal symptoms in migraine: a REFORM study

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