Background

Dopaminergic symptoms may be extremely pronounced in some migraine patients during the attack, representing a major source of disability.

Objectives

We aimed to carefully characterize the clinical picture of migraine patients with dopaminergic symptoms in a large patients’ population as a putative migraine endophenotype, allowing more precise disease management, treatment and outcome prediction.

Methods

We screened 1148 consecutive tertiary care episodic and chronic migraine patients with face-to-face interviews collecting thorough data on lifestyle, socio-demographic factors, and clinical migraine features.

Results

We identified 374 patients with migraine with dopaminergic symptoms (32.6%). The most frequent dopaminergic symptom was yawning followed by somnolence, nausea, vomiting, fatigue, mood changes and diuresis. Migraine patients with dopaminergic symptoms had longer attack duration (OR: 1.82; 95% CI: 1.41–2.36, p < 0.0001), more frequent osmophobia (OR: 2.01; 95% CI: 1.50–2.69, p < 0.0001), allodynia (OR: 1.43; 95% CI: 1.10–1.85, p = 0.0071) and unilateral cranial autonomic symptoms (OR: 1.31; 95% CI: 1.01–1.68, p = 0.045), but used less preventative treatments (OR: 0.74; 95% CI: 0.57–0.98, p = 0.033) than patients without dopaminergic symptoms.

Conclusions

Migraine patients with dopaminergic symptoms are characterized by a full-blown, more disabling migraine. Dopaminergic system modulation should be carefully considered in individuals with migraine with dopaminergic symptoms for both acute and preventative treatments in future ad hoc designed studies.

中文翻译：

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偏头痛中的多巴胺能症状：对 1148 名连续头痛中心患者的横断面研究。

背景

在发作期间，一些偏头痛患者的多巴胺能症状可能非常明显，这是导致残疾的主要来源。

目标

我们的目标是在大量患者群体中仔细描述具有多巴胺能症状的偏头痛患者的临床表现，作为推定的偏头痛内表型，从而实现更精确的疾病管理、治疗和结果预测。

方法

我们通过面对面访谈对 1148 名连续的三级保健发作性和慢性偏头痛患者进行了筛查，收集了有关生活方式、社会人口因素和临床偏头痛特征的全面数据。

结果

我们确定了 374 名有多巴胺能症状的偏头痛患者 (32.6%)。最常见的多巴胺能症状是打哈欠，其次是嗜睡、恶心、呕吐、疲劳、情绪变化和利尿。有多巴胺能症状的偏头痛患者的发作持续时间更长（OR：1.82；95% CI：1.41-2.36，p  < 0.0001），更频繁的渗透恐惧症（OR：2.01；95% CI：1.50-2.69，p  < 0.0001）， OR：1.43；95% CI：1.10–1.85，p  = 0.0071）和单侧颅自主神经症状（OR：1.31；95% CI：1.01–1.68，p  = 0.045），但使用较少的预防性治疗（OR：0.74； % CI: 0.57–0.98, p  = 0.033) 与没有多巴胺能症状的患者相比。

结论

具有多巴胺能症状的偏头痛患者的特征是全面的、更致残的偏头痛。在未来特别设计的研究中，应仔细考虑对具有多巴胺能症状的偏头痛患者进行急性和预防性治疗时的多巴胺能系统调节。