Keywords
chronic migraine
chronic tension headache
pain assessment
ROC analysis
prognosis
How to Cite
Abstract
Introduction. Chronic headache, including migraine and tension-type headache, affects a significant proportion of the population worldwide, posing a serious challenge to the healthcare system. Although diagnostic techniques are constantly improving, the definition of chronic primary headache remains a challenging task.
Aim. To evaluate the effectiveness of integrating specialized scales and questionnaires to improve the diagnosis and prognosis of chronic tension-type headache and chronic migraine.
Materials and methods. The study included 61 individuals diagnosed with “Chronic Tension Headache” (CTH) or “Chronic Migraine” (CM) (according to the International Classification of Headache-3), and 18 individuals control group without chronic headache. All patients underwent a clinical and neurological examination and assessment using scales and questionnaires that determined the qualitative and quantitative characteristics of pain, concomitant symptoms, and quality of life of patients. To determine the discriminatory ability of the questionnaires used in the study for differentiating between CTH and CM, a correlation analysis and ROC curve were conducted.
Results. The study revealed mainly strong direct correlations between the results of the McGill pain questionnaire (MPQ), the headache severity questionnaire НIT-6, the hospital anxiety and depression scale (HADS) and the visual analogue scale (VAS) in patients. A direct relationship was determined between the intensity of pain on the visual analogue scale and the HIT-6 score. The best operational characteristics (the highest sensitivity and specificity, AUC) were: the headache severity questionnaire HIT-6 (Se=96.67%; Sp=96.77%; AUC=0.990; p<0.01); MPQ: motivational-affective component (Se=100%; Sp=87.1%; AUC=0.990; p<0.01); visual analogue scale (Se=90%; Sp=96.77%; AUC=0.981; p<0.01); and the McGill pain questionnaire: sensory-discriminative component (Se=96.67%; Sp=100%; AUC=0.971; p<0.01).
Conclusions. The HIT-6, Visual Analogue Scale and McGill Pain Questionnaire (motivational-affective and sensory-discriminative components) can be used as an additional tool for differentiating chronic tension-type headache from chronic migraine in patients. The prediction of the course of chronic migraine and chronic headache using questionnaires and scales depends on the severity of anxiety and depression, quality of life indicators and pain characteristics. Questionnaires and scales are relevant additional diagnostic methods in establishing the diagnosis of primary headache.
References
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: An update on burden, best practices, and new advances. The Lancet, 397(10289), 2082-2097. https://doi.org/10.1016/S0140-6736(21)00393-7.
Bottiroli, S., Renzi, A., Ballante, E., De Icco, R., Sances, G., Tanzilli, A., Vecchi, T., Tassorelli, C., & Galli, F. (2023). Personality in chronic headache: A systematic review with meta-analysis. Pain Research and Management, 2023, 6685372. https://doi.org/10.1155/2023/6685372.
Stovner, L. J., Hagen, K., Linde, M., & Steiner, T. J. (2022). The global prevalence of headache: An update, with analysis of the influences of methodological factors on prevalence estimates. The Journal of Headache and Pain, 23(1), 34. https://doi.org/10.1186/s10194-022-01402-2.
Headache Classification Committee of the International Headache Society (IHS). (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1-211. https://doi.org/10.1177/0333102417738202
Andreou, A. P., & Edvinsson, L. (2019). Mechanisms of migraine as a chronic evolutive condition. The Journal of Headache and Pain, 20(1), 1-17. https://doi.org/10.1186/s10194-019-1066-0
Patterson Gentile, C., Hershey, A. D., & Szperka, C. L. (2024). A critical appraisal of the International Classification of Headache Disorders migraine diagnostic criteria based on a retrospective multicenter cross-sectional headache registry study in youth. Headache, 64(10), 1217-1229. https://doi.org/10.1111/head.14858
Bukreieva, Y., & Kalbus, O. (2024). Chronic headache. Chronic migraine with daily headache (literature review). UKR.MED.CHASOPYS, 4(162) – VII/VIII. https://doi.org/10.32471/umj.1680-3051.162.252564
Elizagaray-García, I., Carvalho, G. F., Szikszay, T. M., Adamczyk, W. M., Navarro-Fernández, G., Alvarez-Testillano, P., Díaz-de-Terán, J., Luedtke, K., & Gil-Martínez, A. (2022). Psychophysical testing in chronic migraine and chronic tension type headache: An observational study. Cephalalgia, 42(7), 618-630. https://doi.org/10.1177/03331024211060315.
Chaban, O. O., & Khaustova, O. O. (Eds.). (2019). Practical psychosomatics: Diagnostic scales (2nd ed., revised and supplemented). Kyiv: Medknyga Publishing House. ISBN 978-966-1597-65-4.
Pradela, J., Bevilaqua-Grossi, D., Chaves, T. C., Dach, F., & Carvalho, G. F. (2021). Measurement properties of the Headache Impact Test (HIT-6™ Brazil) in primary and secondary headaches. Headache, 61(3), 527-535. https://doi.org/10.1111/head.14049.
Saltychev, M., Pylkäs, K., Karklins, A., & Juhola, J. (2024). Psychometric properties of neck disability index - a systematic review and meta-analysis. Disability and Rehabilitation, 46(23), 5415-5431. https://doi.org/10.1080/09638288.2024.2304644
Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220-233. https://doi.org/10.1097/00005650-199603000-00003
Hruzieva, T. C., Liehan, V. M., Ogniev, V. A., Нaliienko, L. I., Kriachkova, L. V., & Palamar, B. I. (2020). [Biostatistics]. Vinnytsia: Nova knyha.
Schober, P., & Vetter, T. R. (2021). Logistic regression in medical research. Anesthesia & Analgesia, 132(2), 365-366. https://doi.org/10.1213/ANE.0000000000005247
Nahm, F. S. (2022). Receiver operating characteristic curve: Overview and practical use for clinicians. Korean Journal of Anesthesiology, 75(1), 25-36. https://doi.org/10.4097/kja.21209
González de la Flor, Á., García Pérez de Sevilla, G., Domíngez Balmaseda, D., Martín Vera, D., Montero Martínez, M., & Del Blanco Muñiz, J. Á. (2022). Relationship between self-efficacy and headache impact, anxiety, and physical activity levels in patients with chronic tension-type headache: An observational study. Behavioural Neurology, 2022, 8387249. https://doi.org/10.1155/2022/8387249
Onan, D., Younis, S., Wellsgatnik, W. D., Farham, F., Andruškevičius, S., Abashidze, A., Jusupova, A., Romanenko, Y., Grosu, O., Moldokulova, M. Z., Mursalova, U., Saidkhodjaeva, S., Martelletti, P., & Ashina, S. (2023). Debate: Differences and similarities between tension-type headache and migraine. The Journal of Headache and Pain, 24(1), 92. https://doi.org/10.1186/s10194-023-01614-0.
Hagen, K., Åsberg, A. N., Uhlig, B. L., Tronvik, E., Brenner, E., & Sand, T. (2019). The HUNT4 study: The validity of questionnaire-based diagnoses. The Journal of Headache and Pain, 20(1), 70. https://doi.org/10.1186/s10194-019-1021-0
Sastry, A. S., Kumar, A., Pathak, A., Chaurasia, R. N., Singh, V. K., Joshi, D., Singh, V., & Mishra, V. N. (2023). The pattern of primary headache in the North India population: A hospital-based study. International Journal of Neuroscience, 133(11), 1262-1270. https://doi.org/10.1080/00207454.2022.2075359.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.