BACKGROUND

Polypharmacy in patients with chronic disease such as Migraine Headache poses potential harm in patients such that psychological distress may come in. In relation to psychological distress, Migraine Headache patients with multiple drug use are at increased risk of anxiety and depression.

The main objective of the study is to determine the association between anxiety and depression to polypharmacy in migraine headache patients by using the data in the PNA One Headache Database.

We utilized the data obtained from the Philippine Neurological Association One (PNA-1) Headache Database from 2021 to 2024 and determine the association between Anxiety and Depression to Polypharmacy in patients with Migraine.

The number of medications taken by patients does not significantly differ across depression and anxiety levels, indicating that polypharmacy has no impact on patient’s depression and anxiety. However, the study found that patients with anxiety have more tendency to report more severe headache.

The study highlights that participants, primarily middle-aged women, experience chronic headaches with high pain severity, often lasting for hours. Educational attainment may influence headache management compliance with a large proportion having only elementary education. Headache onset typically begins in early adulthood, and medication effectiveness often diminishes over time suggesting potential tolerance issues. Anxiety is associated with reporting of increased headache severity while depression does not significantly impact headache characteristics or polypharmacy. The findings emphasize the need for targeted interventions and revised treatment strategies to improve headache management outcomes.

INTRODUCTION

Virtual learning is the new normal brought about by the pandemic in the field of education. Consequently, students are compelled to have increased exposure to electronic screens. With digital eye strain caused by increased exposure to gadgets, this study will look for a correlation between exposure to electronic screens and the severity and frequency of headaches and migraines among students studying online.

This study aims to gain an understanding of the average exposure of students to electronic screens and if there is a high frequency of migraine due to this increased exposure so that school administrators are aware of this; and in turn, to serve as a stepping stone for future studies in the same field of research.

This study will make use of an observational comparative design also known as a cross-sectional descriptive study in order to look into the proportion of students affected by such a phenomenon at one point in time. The chosen study population will consist of medicine students currently enrolled in the University of Santo Tomas, Faculty of Medicine and Surgery. The study will make use of questionnaires in order to gather data from the sample population.

Our research study indicates a significant direct correlation as evidenced by both the Pearson correlation coefficient of 0.386 and the p-value of 0.050 between electronic screen exposure and migraine frequency/severity among UST medicine students engaged in online distance learning.

While this correlation underscores the potential health impact of prolonged screen time, the moderately low association suggests a need for cautious interpretation. Other factors explored, such as gender and year level, exhibited positive correlations of 0.283 and 2.955, respectively, but did not reach statistical significance, possibly due to the small sample size limiting the depth of analysis.

Our study highlights a significant correlation between screen time exposure and migraine severity, suggesting the need for schools adopting online or hybrid setups to consider screen hours in their policies. Given the emergence of online learning environments, these factors require careful consideration. While exploring additional factors like gender and year level, limited sample size hindered conclusive findings. Future research should focus on increasing sample size and investigating variables such as screen time quality, exposure environment and participant demographics to better understand the primary causes predisposing individuals to migraine without aura.

OBJECTIVE: To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism. METHODS: A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT₄), Neifenmi (CO₁₈), Jiaogan (AH_6a), Nie (AT₂), Zhen (AT₃), Shenmen (TF₄) and Yidan (CO₁₁). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E₂) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment. RESULTS: Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E₂ and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05). CONCLUSION Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E₂ and 5-HT to improve the level of hormone in the body.
Female ; Humans ; Acupuncture, Ear ; Bloodletting ; Serotonin ; Capsules ; Flunarizine ; Qi ; Quality of Life ; Migraine Disorders/drug therapy* ; Headache/therapy* ; Treatment Outcome ; Acupuncture Points

The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.
Humans ; Moxibustion ; Acupuncture Therapy ; Meridians ; Acupuncture Points ; Headache/therapy* ; Migraine Disorders/therapy*

Migraine is the most common disabling primary headache with a significant socioeconomic burden. At present, some emerging drugs for migraine preventive treatment are under investigation internationally, which significantly promote the progress of migraine treatment. However, only few of this trial for migraine treatment are explored in China. In order to promote and standardize controlled clinical trials of migraine preventive therapy in China, and to provide methodological guidance for the design, implementation and evaluation of clinical trials, the Headache Collaborators of Chinese Society of Neurology formulated this consensus.
Humans ; Adult ; Consensus ; Migraine Disorders/therapy* ; Headache ; China ; Neurology

Migraine is a highly disabling primary headache disease, accompanied by nausea, emesis, photophobia and phonophobia. Chronic migraine is usually developed from episodic migraine, and usually comorbids with anxiety, depression, and sleep disorders, further aggravating the disease burden. At present, the clinical diagnosis and treatment of migraine in China are not standard, and the migraine medical quality control evaluation system is lacking. In order to achieve standardized diagnosis and treatment of migraine, headache collaborators of Chinese Society of Neurology, based on national and international clinical research on diagnosis and treatment of migraine and combined with the current situation of China's medical system, drafted the expert consensus on the medical quality evaluation of inpatients with chronic migraine.
Humans ; Consensus ; Migraine Disorders/diagnosis* ; Nausea ; Photophobia/diagnosis* ; Headache

Objective: To recognize the potential factors that contribute to the eradication of migraine headache in patients with patent foramen ovale (PFO) at one year after percutaneous closure. Methods: A prospective cohort study was conducted, which enrolled patients diagnosed with migraines and PFO at the Department of Structural Heart Disease, First Affiliated Hospital of Xi'an Jiaotong University between May 2016 and May 2018. The patients were segregated into two groups based on their response to treatment, and one group showed elimination of migraines while another did not. Elimination of migraines was defined as a Migraine Disability Assessment Score (MIDAS) score of 0 at one year postoperatively. Least Absolute Shrinkage and Selection Operator (LASSO) regression model was utilized to identify the predictive variables for migraine elimination post-PFO closure. Multiple logistic regression analysis was employed to determine the independent predictive factors. Results: The study enrolled a total of 247 patients, with an average age of (37.5±13.6) years, comprising 81 male individuals (32.8%). One year after closure, 148 patients (59.9%) reported eradication of their migraines. Multivariate logistic regression analysis revealed that migraine with or without aura (OR=0.003 9, 95%CI 0.000 2-0.058 7, P=0.000 18), a history of antiplatelet medication use (OR=0.088 2, 95%CI 0.013 7-0.319 3, P=0.001 48) and resting right-to-left shunt (RLS) (OR=6.883 6, 95%CI 3.769 2-13.548 0, P<0.001) were identified as independent predictive factors for elimination of migraine. Conclusion: Migraine with or without aura, a history of antiplatelet medication use, and resting RLS are the independent prognostic factors associated with elimination of migraine. These results provide important clues for clinicians to choose the optimal treatment plan for PFO patients. However, further studies are needed to confirm these findings.
Humans ; Male ; Young Adult ; Adult ; Middle Aged ; Foramen Ovale, Patent/surgery* ; Prospective Studies ; Heart Diseases ; Hospitals ; Migraine Disorders/surgery*

OBJECTIVE: To observe the effects of moxibustion at "Baihui" (GV 20) and "Dazhui" (GV 14) at different time points on the serum level of β-endorphin (β-EP), substance P (SP) and expression of interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2) protein in brainstem in rats with migraine, and to explore the effect and mechanism of moxibustion in preventing and treating migraine. METHODS: Forty male SD rats were randomly divided into a blank group, a model group, a prevention+treatment (PT) group and a treatment group, 10 rats in each group. Except the blank group, the rats in the remaining groups were injected with nitroglycerin subcutaneously to prepare migraine model. The rats in the PT group were treated with moxibustion 7 days before modeling (once a day) and 30 min after modeling, while the rats in the treatment group were treated with moxibustion 30 min after modeling. The "Baihui" (GV 20) and "Dazhui" (GV 14) were taken for 30 minutes each time. The behavioral scores in each group were observed before and after modeling. After intervention, ELISA method was used to detect the serum level of β-EP and SP; the immunohistochemistry method was used to detect the number of positive cells of IL-1β in brainstem; the Western blot method was used to detect the expression of COX-2 protein in brainstem. RESULTS: Compared with the blank group, the behavioral scores in the model group were increased 0-30 min, 60-90 min and 90-120 min after modeling (P<0.01); compared with the model group, in the treatment group and the PT group, the behavioral scores were decreased 60-90 min and 90-120 min after modeling (P<0.01). Compared with the blank group, in the model group, the serum level of β-EP was decreased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β in brainstem and the expression of COX-2 protein were increased (P<0.01). Compared with the model group, in the PT group and and the treatment group, the serum level of β-EP was increased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β and the expression of COX-2 protein in brainstem were decreased (P<0.01, P<0.05). Compared with the treatment group, in the PT group, the serum level of β-EP was increased and COX-2 protein expression was decreased (P<0.05). CONCLUSION Moxibustion could effectively relieve migraine. The mechanism may be related to reduce the serum level of SP, IL-1β and COX-2 protein expression in brainstem, and increase the serum level of β-EP, and the optimal effect is observed in the PT group.
Rats ; Male ; Animals ; Moxibustion ; Rats, Sprague-Dawley ; Cyclooxygenase 2 ; beta-Endorphin ; Substance P ; Interleukin-1beta ; Migraine Disorders ; Brain Stem

The article presents an original method for the automatic assessment of the quality of event-related potentials (ERPs), based on the calculation of the coefficient ε, which describes the compliance of recorded ERPs with some statistically significant parameters. This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines. The frequency of migraine attacks was correlated with the spatial distribution of the coefficients ε, calculated for EEG channels. More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region. Patients with infrequent migraines exhibited maximum quality in the frontal areas. The automatic analysis of spatial maps of the coefficient ε demonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.
Humans ; Chronic Pain ; Evoked Potentials ; Migraine Disorders/psychology* ; Occipital Lobe ; Electroencephalography

OBJECTIVE: To compare the clinical effect between heat-sensitive moxibustion and mild moxibustion for migraine without aura. METHODS: A total of 54 patients with migraine without aura were randomized into an observation group (27 cases, 2 cases dropped off) and a control group (27 cases, 2 cases dropped off). The basic western medication treatment was adopted in the two groups. In the control group, mild moxibustion was applied at Shuaigu (GB 8), Fengchi (GB 20) and Yanglingquan (GB 34) on the affected side. In the observation group, the frequent acupoint areas of the affected side i.e. Shuaigu (GB 8), Fengchi (GB 20), Taiyang (EX-HN 5), Taichong (LR 3), Yanglingquan (GB 34) were determined, 3 acupoints with strong heat-sensitive sensation were selected each time and mild moxibustion was adopted. The treatment was given once a day, 5 times of treatment was as one course and 2 courses were required in the two groups. Before and after treatment, the scores of migraine symptom, visual analogue scale (VAS), migraine specific quality of life questionnaire (MSQ) were observed, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the scores of migraine symptom and VAS were decreased compared with those before treatment (P<0.01), while the MSQ scores were increased compared with those before treatment (P<0.01) in the two groups. After treatment, the scores of migraine symptom and VAS in the observation group were lower than those in the control group (P<0.05), while the MSQ score in the observation group was higher than that in the control group (P<0.01). The total effective rate was 92.0% (23/25) in the observation group, which was superior to 72.0% (18/25) in the control group (P<0.05). CONCLUSION Both heat-sensitive moxibustion and mild moxibustion can effectively alleviate the clinical symptoms, improve the headache degree and life quality in patients with migraine without aura, the clinical efficacy of heat-sensitive moxibustion is superior to that of mild moxibustion.
Humans ; Moxibustion ; Acupuncture Therapy ; Migraine without Aura/therapy* ; Hot Temperature ; Quality of Life ; Acupuncture Points ; Treatment Outcome