Estudio: Migrañas y SFC - comparación dos estudios

[elipoarch]

[t]Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of
two prospective cross-sectional studies[/t]
Murugan K Ravindran , Yin Zheng , Christian Timbol , Samantha J Merck
and James N Baraniuk
BMC Neurology 2011, 11:30doi:10.1186/1471-2377-11-30
Published: 5 March 2011

Abstract (provisional)
Background
Headaches are more frequent in Chronic Fatigue Syndrome (CFS) than
healthy control (HC) subjects. The 2004 International Headache Society
(IHS) criteria were used to define CFS headache types.

Methods
Subjects in Cohort 1 (HC = 368; CFS = 203) completed questionnaires
about many diverse symptoms by giving nominal (yes/no) answers. Cohort
2 (HC = 21; CFS =67) had more focused evaluations. They scored symptom
severities on 0 to 4 anchored ordinal scales, and had structured
headache evaluations. All subjects had history and physical
examinations; assessments for exclusion criteria; questionnaires about
CFS related symptoms (0 to 4 scale), Multidimensional Fatigue
Inventory (MFI) and Medical Outcome Survey Short Form 36 (MOS SF-36).

Results
Demographics, trends for the number of diffuse "functional" symptoms
present, and severity of CFS case designation criteria symptoms were
equivalent between CFS subjects in Cohorts 1 and 2. HC had
significantly fewer symptoms, lower MFI and higher SF-36 domain scores
than CFS in both cohorts.

Migraine headaches were found in 84%, and tension-type headaches in
81% of Cohort 2 CFS. This compared to 5% and 45%, respectively, in HC.

The CFS group had migraine without aura (60%; MO; CFS+MO), with aura
(24%; CFS+MA), tension headaches only (12%), or no headaches (4%).
Co-morbid tension and migraine headaches were found in 67% of CFS.
CFS+MA had higher severity scores than CFS+MO for the sum of scores
for poor memory, dizziness, balance, and numbness ("Neuro-construct",
p=0.002) and perceived heart rhythm disturbances, palpitations and
noncardiac chest pain ("Cardio-construct"; p=0.045, t-tests after
Bonferroni corrections). CFS+MO subjects had lower pressure-induced
pain thresholds (2.36 kg [1.95-2.78; 95% C.I.] n=40) and a higher
prevalence of fibromyalgia (47%; 1990 criteria) compared to HC (5.23
kg [3.95-6.52] n=20; and 0%, respectively).

Sumatriptan was beneficial for 13 out of 14 newly diagnosed CFS
migraine subjects.

Conclusions
CFS subjects had higher prevalences of MO and MA than HC, suggesting
that mechanisms of migraine pathogenesis such as central sensitization
may contribute to CFS pathophysiology.

Clinical Trial Registration: Georgetown University IRB # 2006-481,
ClinicalTrials.gov NCT00810329.


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