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EHMTI-0169. Trajectories of headache days over one year (5 waves) in chronic and episodic migraineurs participating in the chronic migraine epidemiology and outcomes (cameo) study

Introduction

Within-person variation in headache (HA) frequency and the nature and predictors of this variation have rarely been studied.

Aims

To determine variation and predictors of HA days/month in persons with episodic (EM) or chronic migraine (CM).

Methods

CaMEO was a longitudinal US survey employing quota sampling for screening 80,783 respondents to identify persons with migraine. Baseline HA day frequency was classified as EM (modified ICHD-3b migraine diagnosis, <15 HA days/month for past 3 months) or CM (modified ICHD-3b diagnosis, ≥15 HA days/month for past 3 months). Migraineurs completed quarterly surveys over 5 waves (~1 year) assessing HA symptoms and frequency. Using repeated measures regression modeling, we describe variation in HA days within/between individuals, and evaluate potential variation predictors.

Results

From 58,418 useable returns, we identified 16,789 migraineurs at baseline (EM: 15,313 [91.2%], CM: 1,476 [8.8%]). The reported number of HA days/month showed cyclic variation over time within and between respondents with both CM and EM. HA days increased more for CM (vs EM) persons over time (quarterly RR=1.26, 95% CI 1.20–1.33; P<0.0001). A comprehensive graphical decomposition of this interaction will be presented.

Conclusion

Substantial within- and between-person heterogeneity in quarterly estimates of HA days/month was observed, and resulting trajectories differed between groups. The number of HA days/month increased 26% more per quarter for persons with CM vs EM, possibly resulting from a lowered threshold for migraine initiation, creating positive feedback leading to more attacks.

Funding

Allergan

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Correspondence to RB Lipton.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Lipton, R., Serrano, D., Adams, A. et al. EHMTI-0169. Trajectories of headache days over one year (5 waves) in chronic and episodic migraineurs participating in the chronic migraine epidemiology and outcomes (cameo) study. J Headache Pain 15, D4 (2014). https://doi.org/10.1186/1129-2377-15-S1-D4

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  • DOI: https://doi.org/10.1186/1129-2377-15-S1-D4

Keywords

  • Migraine
  • Repeated Measure
  • Variation Predictor
  • Positive Feedback
  • Lowered Threshold