title: Migraine features in migraineurs with and without anxiety-depression symptoms: a hospital-based study.
abstract: BACKGROUND
  Migraine, anxiety and depression often coexist. A "neurolimbic" model of migraine has been recently proposed accounting for a dynamic influence of pain, mood and anxiety on the migraine disease. However, very few data exist concerning clinical migraine features in patients reporting anxiety-depression symptoms.
  
  
  OBJECTIVE
  Aim of our study was to test differences in clinical migraine features between migraineurs with anxiety-depression symptoms and migraineurs without ones.
  
  
  METHODS
  We recruited 200 consecutive migraineurs. Other primary headaches comorbidity and migraine prophylaxis were exclusion criteria. Each patient was interviewed following a structured questionnaire including general features about migraine, triggers, allodynia. Anxiety and depression symptoms were evaluated in each patient by two brief self-reported scales: the generalized anxiety disorder 7-item scale (GAD-7) and the Patient Health Questionnaire 9-item scale (PHQ-9). A cut-off of 5 in both the GAD-7 and the PHQ-9 was considered positive for the presence of anxiety-depressive symptoms.
  
  
  RESULTS
  One hundred and one patients (51.5%) had anxiety-depression symptoms (GAD-7 and PHQ-9 ≥ 5). They reported a more headaches/month (p = 0.004), higher number of triggers (p < 0.001), and were more allodynic (p = 0.005). In a binary logistic regression model triggers and allodynia made a unique statistical contribution on reporting anxiety-depression symptoms.
  
  
  CONCLUSIONS
  Our results showed that the presence of anxiety-depression symptoms affects migraine clinical presentation. They are associated with enhanced migraine triggers susceptibility, more ictal allodynic symptoms as well as more headaches/month. An altered sensation in migraineurs with anxiety-depression symptoms could be a result of a lower pain threshold and an increased cortical excitability in a broader context of a neurolimbic dysfunction.
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy. Electronic address: filippo.baldacci@unipi.it.
authors: Filippo
authors: F
authors: Baldacci
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Cinzia
authors: C
authors: Lucchesi
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Martina
authors: M
authors: Cafalli
authors: Department of Mental Health and Pathological Addiction, AUSL of Reggio Emilia, Reggio Emilia, Italy.
authors: Michele
authors: M
authors: Poletti
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Martina
authors: M
authors: Ulivi
authors: Neurology Unit, Hospital of Bergamo, Bergamo, Italy.
authors: Marcella
authors: M
authors: Vedovello
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Martina
authors: M
authors: Giuntini
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Sonia
authors: S
authors: Mazzucchi
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Eleonora
authors: E
authors: Del Prete
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Andrea
authors: A
authors: Vergallo
authors: Neurology Unit, Hospital of Viareggio, Viareggio, Italy.
authors: Angelo
authors: A
authors: Nuti
authors: Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy.
authors: Sara
authors: S
authors: Gori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Allodynia; Anxiety; Depression; Migraine; Triggers