title: Fatigue, sleep-wake pattern, depressive and anxiety symptoms and body-mass index: analysis in a sample of episodic and chronic migraine patients.
abstract: Migraine clinical presentation and life-time course can be highly heterogeneous, with a subgroup of patients developing chronic migraine; moreover, migraine clinical spectrum is expanded by the association with different coexisting conditions and interictal dysfunctions. The aim of this study was to systematically evaluate migraine clinical features, daily functioning parameters, sleep pattern, presence of depressive-anxiety symptoms and body mass index (BMI) in a sample of 75 episodic and 75 chronic migraine without aura patients. Migraine-related disability, fatigue, daily sleepiness, subjective sleep quality, anxiety and depressive symptoms were, respectively, evaluated using the following questionnaires: Fatigue Severity Scale (FSS), Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder 7-item Scale (GAD-7), Patient Health Questionnaire 9-item Scale (PHQ-9). Mean FSS score (p < 0.001), PSQI score (p = 0.015), GAD-7 score (p = 0.019), PHQ-9 score (p < 0.001) and BMI score (p = 0.012) were significantly higher in chronic compared to episodic migraineurs. Additionally, a correlation analysis carried out in the total sample of 150 migraine patients documented a statistically significant, positive correlation between monthly frequency of migraine attacks and FSS score (p < 0.001), PSQI score (p = 0.006), GAD-7 score (p = 0.019), PHQ-9 score (p < 0.001) and BMI score (p = 0.049). Data from the present report seem to expand the concept of migraine as a continuum or spectrum, with greater occurrence of fatigue, poor sleep quality, anxiety-depressive symptoms and higher BMI score in chronic compared to episodic migraine patients; further investigation is certainly necessary to better define the biological basis and mechanisms associated with migraine transformation from episodic to chronic pattern.
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy. cinzia.lucchesi@gmail.com.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Lucchesi
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Baldacci
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Cafalli
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Dini
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Giampietri
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Siciliano
authors.affiliation: Department of Clinical and Experimental Medicine, Institute of Neurology, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gori
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000145:classification / Q000150:complications*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Body-mass index; Chronic migraine; Episodic migraine; Fatigue; Psychiatric disorders; Sleep quality