The influence of concomitant cervicalgia on the psycho-emotional and autonomic state and daily activity in patients with episodic migraine

O. Dubenko, A. Chernenko
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Abstract

The aim of the work is to study the occurrence of psycho-emotional and autonomic disturbance and the impact of headache on the daily activities of patients with episodic migraine, depending on the presence of concomitant cervicalgia. Materials and methods: 77 patients with episodic migraine (17 with aura, 60 without aura, 28 men and 84 women, 18-58 years, mean 42.5±15.5 years) were included. 42 of them had concomitant cervicalgia. All patients were divided into 2 groups: I – episodic migraine with concomitant cervicalgia, II – episodic migraine without neck pain. The Spilberg-Hanin's anxiety scale, the Beck depression scale, Wayne questionnaire, Neck Disability Index and the MIDAS were used. Results. The number of psycho-emotional disorders was higher in group patients with combined episodic migraine and cervicalgia (p<0.05). The indicators of autonomic disturbance were also higher in I group (p<0.05). The indicators depression correlated with autonomic status on subjective signs symptoms of (r=0.380) and objective signs (r=0.554). In I group the autonomic disturbance on subjective signs correlated with state anxiety (r=0.312), trait anxiety (r=0.348) and Beck scale (r=0.351). In group II autonomic objective signs correlated with the patient’s self-assessment on the same scale (r=0.919). The level of neck disability on NDI correlated with autonomic dysfunction on objective signs (r=0.338) in I group. The decrease of daily activity was more significantly reduce on MIDAS in I group compare with II group. Conclusion. The combination of episodic migraine and cervicalgia in patients significantly reduces the daily activity rate on the MIDAS. The concomitant cervicalgia in patients with episodic migraine to contribute increase rates of state and trait anxiety and mild depressive symptoms and autonomic disturbance
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伴发性颈痛对发作性偏头痛患者心理情绪、自主神经状态及日常活动的影响
这项工作的目的是研究心理情绪和自主神经障碍的发生,以及头痛对发作性偏头痛患者日常活动的影响,这取决于伴随颈痛的存在。材料和方法:纳入发作性偏头痛患者77例(先兆17例,无先兆60例,男性28例,女性84例,年龄18-58岁,平均42.5±15.5岁)。42例伴有颈痛。所有患者分为2组:1 -发作性偏头痛伴颈痛,2 -发作性偏头痛无颈痛。采用Spilberg-Hanin焦虑量表、Beck抑郁量表、Wayne问卷、颈部残疾指数和MIDAS量表。发作性偏头痛合并颈痛组的心理情绪障碍发生率较高(p<0.05)。自主神经障碍各项指标I组均高于对照组(p<0.05)。主观症状体征(r=0.380)和客观症状体征(r=0.554)抑郁与自主神经状态相关。I组主观体征自主神经障碍与状态焦虑(r=0.312)、特质焦虑(r=0.348)、Beck量表(r=0.351)相关。II组自主客观体征与患者同一量表的自我评价相关(r=0.919)。I组NDI患者颈部残疾程度与客观体征自主神经功能障碍相关(r=0.338)。与ⅱ组相比,ⅰ组患者MIDAS的日活动量下降更明显。发作性偏头痛和颈痛患者的组合显著降低了MIDAS的日常活动率。发作性偏头痛患者伴随的颈痛增加了状态性和特质性焦虑、轻度抑郁症状和自主神经障碍的发生率
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