Interictal burden attributable to episodic headache

findings from the Eurolight project

Christian Lampl, Hallie Thomas, Lars Jacob Stovner, Cristina Tassorelli, Zaza Katsarava, Jose Miguel Laínez, Michel Lantéri-Minet, Daiva Rastenyte, Elena Ruiz de la Torre, Colette Andrée, Timothy J. Steiner

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be symptom-free between attacks. We analysed the Eurolight dataset for interictal burden. Methods: Eurolight was a cross-sectional survey using modified cluster sampling from the adult population (18–65 years) in 10 countries of the European Union. We used data from nine. The questionnaire included headache-diagnostic questions based on ICHD-II and several question sets addressing impact, including interictal and cumulative burdens. Results: There were 6455 participants with headache (male 2444 [37.9 %]). Interictal symptoms were reported by 26.0 % of those with migraine and 18.9 % with TTH: interictal anxiety by 10.6 % with migraine and avoidance (lifestyle compromise) by 14.8 %, both much more common than in TTH (3.1 % [OR 3.8] and 4.7 % [OR 3.5] respectively). Mean time spent in the interictal state was 317 days/year for migraine, 331 days/year for TTH. Those who were “rarely” or “never” in control of their headaches (migraine 15.2 %, TTH 9.6 %) had significantly raised odds of interictal anxiety, avoidance and other interictal symptoms. Among those with migraine, interictal anxiety increased markedly with headache intensity and frequency, avoidance less so but still significantly. Lost productive time was associated with high ORs (up to 5.3) of anxiety and avoidance. A third (32.9 %) with migraine and a quarter (26.7 %) with TTH (difference: p <0.0001) were reluctant to tell others of their headaches. About 10 % with each disorder felt families and friends did not understand their headaches. Nearly 12 % with migraine reported their employers and colleagues did not. Regarding cumulative burden, 11.8 % reported they had done less well in education because of headache, 5.9 % reported reduced earnings and 7.4 % that their careers had suffered. Conclusions: Interictal burden in those with episodic headache is common, more so in migraine than TTH. Some elements have the potential to be profoundly consequential. New methodology is needed to measure interictal burden if descriptions of headache burden are to be complete.

Original languageEnglish
Article number9
Pages (from-to)1-10
Number of pages10
JournalJournal of Headache and Pain
Volume17
Issue number1
DOIs
Publication statusPublished - Dec 1 2016

Fingerprint

Migraine Disorders
Tension-Type Headache
Headache
Anxiety
European Union
Life Style
Cross-Sectional Studies
Education
Population

Keywords

  • Eurolight project
  • Europe
  • Global Campaign against Headache
  • Headache
  • Interictal burden
  • Migraine
  • Public health
  • Tension-type headache

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Lampl, C., Thomas, H., Stovner, L. J., Tassorelli, C., Katsarava, Z., Laínez, J. M., ... Steiner, T. J. (2016). Interictal burden attributable to episodic headache: findings from the Eurolight project. Journal of Headache and Pain, 17(1), 1-10. [9]. https://doi.org/10.1186/s10194-016-0599-8

Interictal burden attributable to episodic headache : findings from the Eurolight project. / Lampl, Christian; Thomas, Hallie; Stovner, Lars Jacob; Tassorelli, Cristina; Katsarava, Zaza; Laínez, Jose Miguel; Lantéri-Minet, Michel; Rastenyte, Daiva; Ruiz de la Torre, Elena; Andrée, Colette; Steiner, Timothy J.

In: Journal of Headache and Pain, Vol. 17, No. 1, 9, 01.12.2016, p. 1-10.

Research output: Contribution to journalArticle

Lampl, C, Thomas, H, Stovner, LJ, Tassorelli, C, Katsarava, Z, Laínez, JM, Lantéri-Minet, M, Rastenyte, D, Ruiz de la Torre, E, Andrée, C & Steiner, TJ 2016, 'Interictal burden attributable to episodic headache: findings from the Eurolight project', Journal of Headache and Pain, vol. 17, no. 1, 9, pp. 1-10. https://doi.org/10.1186/s10194-016-0599-8
Lampl, Christian ; Thomas, Hallie ; Stovner, Lars Jacob ; Tassorelli, Cristina ; Katsarava, Zaza ; Laínez, Jose Miguel ; Lantéri-Minet, Michel ; Rastenyte, Daiva ; Ruiz de la Torre, Elena ; Andrée, Colette ; Steiner, Timothy J. / Interictal burden attributable to episodic headache : findings from the Eurolight project. In: Journal of Headache and Pain. 2016 ; Vol. 17, No. 1. pp. 1-10.
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abstract = "Background: Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be symptom-free between attacks. We analysed the Eurolight dataset for interictal burden. Methods: Eurolight was a cross-sectional survey using modified cluster sampling from the adult population (18–65 years) in 10 countries of the European Union. We used data from nine. The questionnaire included headache-diagnostic questions based on ICHD-II and several question sets addressing impact, including interictal and cumulative burdens. Results: There were 6455 participants with headache (male 2444 [37.9 {\%}]). Interictal symptoms were reported by 26.0 {\%} of those with migraine and 18.9 {\%} with TTH: interictal anxiety by 10.6 {\%} with migraine and avoidance (lifestyle compromise) by 14.8 {\%}, both much more common than in TTH (3.1 {\%} [OR 3.8] and 4.7 {\%} [OR 3.5] respectively). Mean time spent in the interictal state was 317 days/year for migraine, 331 days/year for TTH. Those who were “rarely” or “never” in control of their headaches (migraine 15.2 {\%}, TTH 9.6 {\%}) had significantly raised odds of interictal anxiety, avoidance and other interictal symptoms. Among those with migraine, interictal anxiety increased markedly with headache intensity and frequency, avoidance less so but still significantly. Lost productive time was associated with high ORs (up to 5.3) of anxiety and avoidance. A third (32.9 {\%}) with migraine and a quarter (26.7 {\%}) with TTH (difference: p <0.0001) were reluctant to tell others of their headaches. About 10 {\%} with each disorder felt families and friends did not understand their headaches. Nearly 12 {\%} with migraine reported their employers and colleagues did not. Regarding cumulative burden, 11.8 {\%} reported they had done less well in education because of headache, 5.9 {\%} reported reduced earnings and 7.4 {\%} that their careers had suffered. Conclusions: Interictal burden in those with episodic headache is common, more so in migraine than TTH. Some elements have the potential to be profoundly consequential. New methodology is needed to measure interictal burden if descriptions of headache burden are to be complete.",
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AU - Thomas, Hallie

AU - Stovner, Lars Jacob

AU - Tassorelli, Cristina

AU - Katsarava, Zaza

AU - Laínez, Jose Miguel

AU - Lantéri-Minet, Michel

AU - Rastenyte, Daiva

AU - Ruiz de la Torre, Elena

AU - Andrée, Colette

AU - Steiner, Timothy J.

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N2 - Background: Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be symptom-free between attacks. We analysed the Eurolight dataset for interictal burden. Methods: Eurolight was a cross-sectional survey using modified cluster sampling from the adult population (18–65 years) in 10 countries of the European Union. We used data from nine. The questionnaire included headache-diagnostic questions based on ICHD-II and several question sets addressing impact, including interictal and cumulative burdens. Results: There were 6455 participants with headache (male 2444 [37.9 %]). Interictal symptoms were reported by 26.0 % of those with migraine and 18.9 % with TTH: interictal anxiety by 10.6 % with migraine and avoidance (lifestyle compromise) by 14.8 %, both much more common than in TTH (3.1 % [OR 3.8] and 4.7 % [OR 3.5] respectively). Mean time spent in the interictal state was 317 days/year for migraine, 331 days/year for TTH. Those who were “rarely” or “never” in control of their headaches (migraine 15.2 %, TTH 9.6 %) had significantly raised odds of interictal anxiety, avoidance and other interictal symptoms. Among those with migraine, interictal anxiety increased markedly with headache intensity and frequency, avoidance less so but still significantly. Lost productive time was associated with high ORs (up to 5.3) of anxiety and avoidance. A third (32.9 %) with migraine and a quarter (26.7 %) with TTH (difference: p <0.0001) were reluctant to tell others of their headaches. About 10 % with each disorder felt families and friends did not understand their headaches. Nearly 12 % with migraine reported their employers and colleagues did not. Regarding cumulative burden, 11.8 % reported they had done less well in education because of headache, 5.9 % reported reduced earnings and 7.4 % that their careers had suffered. Conclusions: Interictal burden in those with episodic headache is common, more so in migraine than TTH. Some elements have the potential to be profoundly consequential. New methodology is needed to measure interictal burden if descriptions of headache burden are to be complete.

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KW - Eurolight project

KW - Europe

KW - Global Campaign against Headache

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KW - Interictal burden

KW - Migraine

KW - Public health

KW - Tension-type headache

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