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Vol. 47. Issue 1.
Pages 63-71 (January 2024)
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Vol. 47. Issue 1.
Pages 63-71 (January 2024)
Original article
Headache in patients with inflammatory bowel disease: Migraine prevalence according to the Migraine Screening-Questionnaire (MS-Q) and headache characteristics
Cefalea en pacientes con enfermedad inflamatoria intestinal: prevalencia de migraña de acuerdo al Migraine Screening-Questionnaire (MS-Q) y características de la cefalea
Alicia Gonzalez-Martineza,b, Inés Murob, Sonia Quintasa,b,
Corresponding author
sonia.qg@gmail.com

Corresponding author.
, María Chaparroc, Javier P. Gisbertc, Ancor Sanz-Garcíad, María José Casanovac, Cristina Rubín de Célixc, José Vivancosb, Ana Beatriz Gago-Veigaa,b
a Headache Unit, Department of Neurology, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain
b Department of Neurology, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain
c Gastroenterology Unit, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
d Data Analysis Unit, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de la Princesa, Madrid, Spain
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Tables (6)
Table 1. Clinical and demographic characteristics of the sample included in the study.
Table 2. Self-reported headache variables among patients with inflammatory bowel disease and control group among patients with a diagnosis of migraine according to the Migraine Screen-Questionnaire (MS-Q).
Table 3. Characteristics and severity scale score in patients with inflammatory bowel disease.
Table 4. Headache scale scores among patients with ulcerative colitis, Crohn disease and control group with a diagnosis of migraine according to the Migraine Screen-Questionnaire (MS-Q).
Table 5. Demographic and clinical variables associated with the Migraine Screen-Questionnaire (MS-Q) in IBD patients.
Table 6. Relationship between headache variables and IBD variables among patients with migraine diagnosis according to the Migraine Screen-Questionnaire (MS-Q).
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Abstract
Background

The gut-brain axis describes a complex bidirectional association between neurological and gastrointestinal (GI) disorders. In patients with migraine, GI comorbidities are common. We aimed to evaluate the presence of migraine among patients with inflammatory bowel disease (IBD) according to Migraine Screen-Questionnaire (MS-Q) and describe the headache characteristics compared to a control group. Additionally, we explored the relationship between migraine and IBD severities.

Methods

We performed a cross-sectional study through an online survey including patients from the IBD Unit at our tertiary hospital. Clinical and demographic variables were collected. MS-Q was used for migraine evaluation. Headache disability scale HIT-6, anxiety-depression scale HADS, sleep scale ISI, and activity scale Harvey–Bradshaw and Partial Mayo scores were also included.

Results

We evaluated 66 IBD patients and 47 controls. Among IBD patients, 28/66 (42%) were women, mean age 42 years and 23/66 (34.84%) had ulcerative colitis. MS-Q was positive in 13/49 (26.5%) of IBD patients and 4/31 (12.91%) controls (p=0.172). Among IBD patients, headache was unilateral in 5/13 (38%) and throbbing in 10/13 (77%). Migraine was associated with female sex (p=0.006), lower height (p=0.003) and weight (p=0.002), anti-TNF treatment (p=0.035). We did not find any association between HIT-6 and IBD activity scales scores.

Conclusions

Migraine presence according to MS-Q could be higher in patients with IBD than controls. We recommend migraine screening in these patients, especially in female patients with lower height and weight and anti-TNF treatment.

Keywords:
Migraine
Ulcerative colitis
Crohn's disease
Inflammatory bowel disease
Real-world evidence
MS-Q
Abbreviations:
Anti-TNF
CI
CD
GI
IBD
ICHD
IQR
MOH
MS-Q
OR
SD
STROBE
UC
Resumen
Introducción

El eje intestino-cerebro describe una asociación bidireccional compleja entre las enfermedades neurológicas y gastrointestinales (GI). Las comorbilidades GI son frecuentes en la migraña. Nuestro objetivo fue evaluar la presencia de migraña en pacientes con enfermedad inflamatoria intestinal (EII) y describir las características de la cefalea. Además, analizamos la relación entre la gravedad de la migraña y la EII.

Métodos

Estudio transversal a través de encuesta electrónica en pacientes con EII de un hospital terciario. Se recogieron variables clínicas y demográficas. Se usó MS-Q para presencia de migraña. Se incluyeron escala de discapacidad de cefalea HIT-6, ansiedad-depresión HADS, sueño ISI y actividad de EII Harvey-Bradshaw y Partial Mayo.

Resultados

Se incluyeron 66EII y 47controles. Entre los EII, 28/66 (42%) eran mujeres, con una edad media de 42años, y 23/66 (34,84%) tenían colitis ulcerosa. El MS-Q fue positivo en 13/49 (26,5%) de EII y en 4/31 (12,91%) controles (p=0,172). Entre los pacientes con EII, la cefalea fue unilateral en 5/13 (38%) y pulsátil en 10/13 (77%). El sexo femenino (p=0.006), la altura (p=0,003) y el peso más bajos (p=0,002) y el tratamiento con anti-TNF (p=0,035) se relacionaron con la probabilidad de migraña. No encontramos asociación entre el HIT-6 y las escalas de actividad de EII.

Conclusiones

La presencia de migraña de acuerdo al MS-Q podría ser más alta en los pacientes con EII que en controles. Recomendamos realizar un cribado de migraña en estos pacientes, especialmente en mujeres de menor peso y altura y tratamiento anti-TNF.

Palabras clave:
Migraña
Colitis ulcerosa
Enfermedad de Crohn
Enfermedad inflamatoria intestinal
Evidencia vida real
MS-Q

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