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Revue Neurologique Oct 2021A bidirectional relationship appears to connect tension-type headache (TTH) and circadian dysregulation. The present systematic review examined the published evidence... (Review)
Review
BACKGROUND-PURPOSE
A bidirectional relationship appears to connect tension-type headache (TTH) and circadian dysregulation. The present systematic review examined the published evidence for melatonin (MT) supplementation in the prophylaxis of TTH. Initially, we reviewed case-control studies investigating nocturnal MT or 6-sulphatoxymelatonin (aMT6s, a urine-discarded metabolite) in TTH individuals and healthy controls (HC). Secondly, we reviewed studies appraising the use of MT in the prevention of TTH.
METHODS
The search strategy involved MEDLINE EMBASE, CENTRAL, PsycINFO, trial registries, Google Scholar and OpenGrey. Case-control studies were appraised according to the Newcastle-Ottawa-Scale, whereas randomised controlled trials were assessed based on the risk-of-bias Cochrane tool. Infrequent, as well as frequent, episodic, and chronic TTH patients were evaluated separately in children and adults.
RESULTS
Our search strategy yielded two case-control studies. One (high-quality) did not reveal any difference in morning salivary MT concentration between children with frequent episodic TTH and HC. The second (moderate-quality) was indicative of a disturbed nocturnal secretion pattern in adults with chronic TTH. For the second part, five uncontrolled studies were retrieved. In total, 94 adults with chronic TTH were assessed and results were suggestive of a beneficial effect of MT on headache frequency, intensity, induced disability, and induced analgesic consumption. However, the uncontrolled-unblinded designs may have induced an important placebo effect. Non-adult populations and frequent TTH were substantially understudied.
CONCLUSIONS
There are not enough studies to designate the role of MT in the prevention of TTH. Given the disease's background, additional relevant research is warranted for chronic TTH.
Topics: Adult; Analgesics; Case-Control Studies; Child; Humans; Melatonin; Tension-Type Headache
PubMed: 34167809
DOI: 10.1016/j.neurol.2021.01.014 -
Sleep Medicine Reviews Feb 2024Obstructive sleep apnea (OSA) is one of the most common sleep disorders; however, there are inconsistent results about the connection and occurrence of primary and... (Meta-Analysis)
Meta-Analysis Review
Obstructive sleep apnea (OSA) is one of the most common sleep disorders; however, there are inconsistent results about the connection and occurrence of primary and secondary headaches in OSA. Therefore, the primary objectives were to estimate the prevalence and potential relationship between all types of headaches and OSA. A systematic review was conducted according to PRISMA 2020 guidelines. Studies were searched in PubMed, Embase, and Web of science up to July 2023. The Joanna Briggs Institute tool assessed the risk of bias. 1845 articles were identified, and 23 studies describing 15,402 patients were included. Pooled prevalence of all headaches in OSA was 33% (95% CI: 0.25-0.41), 33% for morning headaches (95% CI: 0.24-0.45), 25% for sleep apnea headaches (95% CI: 0.18-0.34), 19% for tension-type headache (95% CI: 0.15-0.23), and 16% for migraine (95% CI: 0.09-0.26). Relative risk for the occurrence of headache in OSA patients compared to the non-OSA people was 1.43 (95% CI: 0.92-2.25). OSA females and males had morning headaches with similar frequency. The prevalence of headaches in OSA was moderate. OSA did not increase the risk of headache. There is a need to conduct further studies focused on bidirectional connections between sleep disorders and headaches.
Topics: Female; Humans; Male; Headache; Prevalence; Risk; Sleep Apnea Syndromes; Sleep Apnea, Obstructive
PubMed: 38056382
DOI: 10.1016/j.smrv.2023.101889 -
Journal of Oral & Facial Pain and...To systematically review the literature assessing associations between TMDs and primary headaches.
AIMS
To systematically review the literature assessing associations between TMDs and primary headaches.
METHODS
Using validated clinical criteria, studies on TMDs and primary headaches published up to January 10, 2023 were identified using six electronic databases. This review adhered to the PRISMA 2020 guidelines and 27-item checklist and is registered on PROSPERO (CRD42021256391). Risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies.
RESULTS
Two independent investigators rated 7,697 records against the primary endpoint and found 8 records meeting the eligibility requirements. Migraine was found to be the most common primary headache related to TMDs (61.5%), followed by episodic tension-type headache (ETTH; 38.5%). A moderate association was found for mixed TMDs with migraine and ETTH, with a large sample size and multiple studies included (n = 8). A very low-quality association was found for myalgia-related TMDs with migraine and ETTH (included studies, n = 2).
CONCLUSION
The association between TMDs and primary headaches is of great interest given the possible effectiveness of TMD management in reducing headache intensity/frequency in patients with TMDs and headache comorbidity. A moderate association was found for mixed TMDs with primary headaches, in particular migraine and ETTH. However, owing to the overall moderate certainty of evidence of the present findings, further longitudinal studies with larger samples investigating possible associated factors and using accurate TMD and headache category assignment are needed.
Topics: United States; Humans; Cross-Sectional Studies; Headache; Migraine Disorders; Tension-Type Headache; Temporomandibular Joint Disorders
PubMed: 37389836
DOI: 10.11607/ofph.3345 -
Annals of Medicine Dec 2022The objective of this meta-analysis was to identify whether headache increase the risk of dry eye disease (DED). (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this meta-analysis was to identify whether headache increase the risk of dry eye disease (DED).
METHODS
PubMed, Web of Science, Cochrane Library and EMBASE databases were searched for relevant studies. The odds ratio (OR) of DED in all-cause headache was calculated Stata software. To explore the source of heterogeneity, subgroup and sensitivity analyses were conducted. Funnel plots and Egger's test were performed to assess publication bias.
RESULTS
This meta-analysis included 11 studies. Pooled analysis indicated that all-cause headache was related to a higher risk of DED (OR = 1.586, 95% CI : 1.409-1.785, = 89.3%, < .001). Migraine headache, tension headache and cluster headache were all related to a higher risk of DED (OR = 1.503, 95% CI: 1.369-1.650, = 81.8%, < .001; OR = 1.610, 95% CI: 1.585-1.635, < .001; OR = 2.120, 95% CI: 1.104-4.073, .024), respectively. The risk of DED in case-control studies was slightly higher than in cross-sectional studies and cohort study (OR = 1.707, 95% CI: 1.291-2.258, = 85.0%, < .001; OR = 1.600, 95% CI: 1.590-1.610, = 0.0%, < .001; OR = 1.440, 95% CI: 1.096-1.893, .009), respectively. Subgroup analysis in territory type showed that all-cause headache in America, Europe, Asia and Oceania were all related to a higher risk of DED.
CONCLUSIONS
This study indicates that headache is related to a higher risk of DED, especially in the migraine patients. These results suggest that headaches should be regarded as an independent risk factor for DED.KEY MESSAGESIn this meta-analysis, 11 studies (one cohort study, four case-control studies and six cross-sectional studies) covering 3,575,957 individuals were included.Pooled analysis indicated that all-cause headache was related to a higher risk of dry eye (OR = 1.586, 95% CI: 1.409-1.785, = 89.3%, < .001).These results suggest that headaches should be regarded as an independent risk factor for dry eye.
Topics: Humans; Cross-Sectional Studies; Cohort Studies; Dry Eye Syndromes; Headache; Migraine Disorders
PubMed: 36259538
DOI: 10.1080/07853890.2022.2133165 -
Cephalalgia : An International Journal... Jan 2023In this manuscript, we aim to systematically estimate the pooled prevalence and incidence of primary headaches and its subtypes (migraine, tension-type headache, and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In this manuscript, we aim to systematically estimate the pooled prevalence and incidence of primary headaches and its subtypes (migraine, tension-type headache, and chronic headaches) in Latin America and the Caribbean, describing its epidemiological profile and associated factors.
METHODS
We systematically searched PubMed/MEDLINE, Scopus, and LILACS (From conception to March 2021), for populational studies reporting the epidemiology of primary headaches and their associated factors in Latin America and the Caribbean. The data extraction was conducted independently. We performed random-effect model meta-analysis of prevalence (overall primary headaches and by subtypes) and associated factors, assessed potential sources of heterogeneity, the risk of bias, publication bias, and the evidence certainty (GRADE methodology).
RESULTS
We included 32 populational studies (38 subpopulations, n = 63,813). The prevalence of primary headaches was 41.4% (95% CI 31.1-52.2%; n = 54,357), 15% for migraine (95% CI 12.0-18.3; n = 53,658 individuals), 20.6% for tension-type headache (95% CI 12.4-30.2; n = 25,840), and 6% for chronic headaches (95% CI 3.3-9.6; n = 21,720), with high between-study heterogeneity. No incidence data was found. Female sex, white ethnicity, high BMI, comorbid mental health disorders, and low-back pain were associated with higher prevalence of primary headaches. The prevalence was less in rural areas.
CONCLUSION
In Latin America and the Caribbean, primary headaches are highly prevalent affecting young females disproportionally. The prevalence of chronic headaches is higher than in other systematic global and regional estimations. The presence of comorbidities as modifiable risk factors should encourage their integration as targets for community-based preventive and therapeutic interventions.
PROTOCOL REGISTRATION NUMBER
CRD42018105116.
Topics: Humans; Female; Tension-Type Headache; Latin America; Ethnicity; Headache; Migraine Disorders; Caribbean Region; Prevalence
PubMed: 36606574
DOI: 10.1177/03331024221128265 -
Scandinavian Journal of Pain Oct 2021The pathogeneses of chronic tension-type headache (CTTH) and cervicogenic headache (CEH) are not well established. Peripheral activation or sensitization of myofascial... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The pathogeneses of chronic tension-type headache (CTTH) and cervicogenic headache (CEH) are not well established. Peripheral activation or sensitization of myofascial nociceptors is suggested as a potential mechanism and injections of botulinum toxin (BONTA) have thus been used in the treatment for both headache conditions. BONTA inhibits the release of acetylcholine at the neuromuscular junction and inhibits contraction of skeletal muscles. If the pain is precipitated by increased tone in cervical muscles, local injections of BONTA could represent a prophylactic measure. However, the treatment is still controversial, and a thorough assessment of the current evidence is required. This review aims to assess the evidence of BONTA injection as a prophylactic treatment for CTTH and CEH by reviewing and examining the quality of placebo-controlled, randomized trials.
METHODS
Data sources: we searched in the following databases: PubMed (including Medline), Embase, Cochrane Central register of Controlled Trials, Cinahl, Amed, SCOPUS and Google Scholar including other repository sources. Both MeSH and free keywords were used in conducting the systematic search in the databases. The search covered publications from the root of the databases to November 2020.
STUDY ELIGIBILITY CRITERIA
The review included RCTs, comparing single treatment of BONTA with placebo on patients with CTTH or CEH above 18 years of age, by measuring pain severity/relief or headache frequency.
DATA EXTRACTION
The following data were extracted: year of publication, country, setting, trial design, number of participants, injection procedure, BONTA dosages, and clinical outcome measures.
STUDY APPRAISAL
To assess validity and quality, and risk of bias, the Oxford Pain Validity Scale, Modified Jadad Scale, last version of Cochrane Collaboration's tool for assessing risk of bias (RoB 2), and the CONSORT 2010 Checklist were used. The trials were assessed, and quality scored independently by two of the reviewers. A quantitative synthesis and meta-analyses of headache frequency and intensity were performed.
RESULTS
We extracted 16 trials, 12 on prophylactic BONTA treatment for CTTH and four on CEH. Of these 12 trials (8 on CTTH and 4 on CEH) were included in the quantitative synthesis. A majority of the trials found no significant difference on the primary outcome measure when BONTA treatment was compared with placebo. Three "positive" trials, reporting significant difference in favor of BONTA treatment, but two of these were hampered by low validity and quality scores and high risk of bias.
CONCLUSIONS
There is no clear clinical evidence supporting prophylactic treatment with BONTA for CTTH or CEH.
Topics: Botulinum Toxins, Type A; Headache; Headache Disorders; Humans; Post-Traumatic Headache; Randomized Controlled Trials as Topic; Tension-Type Headache
PubMed: 34090319
DOI: 10.1515/sjpain-2021-0038 -
BMC Complementary Medicine and Therapies Sep 2021Globally, 3 billion people suffer from either migraine or tension-type headache disorder over their lifetime. Approximately 50% of American adults suffering from...
BACKGROUND
Globally, 3 billion people suffer from either migraine or tension-type headache disorder over their lifetime. Approximately 50% of American adults suffering from headache or migraine have used complementary and alternative medicine (CAM), however, the quality and quantity of recommendations associated with such therapies across clinical practice guidelines (CPGs) for the treatment and/or management of these conditions are unknown. The purpose of this study was to identify the quantity and assess the quality of such CAM recommendations.
METHODS
MEDLINE, EMBASE and CINAHL were systematically searched from 2009 to April 2020; the Guidelines International Network and the National Center for Complementary and Integrative Health websites were also searched for eligible CPGs. CPGs were included if they provided any therapy recommendations. Eligible CPGs included those written for adult patients with headache and migraine; CPGs containing CAM recommendations were assessed twice for quality using the AGREE II instrument, once for the overall CPG and once for the CAM sections.
RESULTS
Of 486 unique search results, 21 CPGs were eligible and quality assessed; fifteen CPGs mentioned CAM, of which 13 CPGs made CAM recommendations. The overall CPG assessment yielded higher scaled domain percentages than the CAM section across all domains. The results from highest to lowest were as follows (overall, CAM): clarity of presentation (66.7% vs. 50.0%), scope and purpose (63.9% vs. 61.1%), stakeholder involvement (22.2% vs. 13.9%), rigour of development (13.5% vs. 9.4%), applicability (6.3% vs. 0.0%), and editorial independence (0.0% vs. 0.0%).
CONCLUSIONS
Of the eligible CPGs, the CAM sections were of lower quality compared to the overall recommendations across all domains of the AGREE II instrument. CPGs that scored well could serve as a framework for discussion between patients and healthcare professionals regarding use of CAM therapies in the context of headache and migraine.
Topics: Complementary Therapies; Headache; Humans; Migraine Disorders; Practice Guidelines as Topic; Practice Patterns, Physicians'; Quality of Health Care
PubMed: 34551759
DOI: 10.1186/s12906-021-03401-3 -
Headache Mar 2022To summarize the evidence regarding static and dynamic balance alterations among patients with headache. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To summarize the evidence regarding static and dynamic balance alterations among patients with headache.
METHODS
Electronic databases (PubMed, CINAHL, and Web of Science) were searched by two researchers independently up to September 2021. Two reviewers selected eligible studies, extracted the data, and assessed the quality of evidence using the Downs and Black checklist. Case-control studies were included if they involved balance assessment of any kind of headache, including objective outcome measures of dynamic and static tests such as body sway displacement, limits of stability (LOS), gait, and tandem walk tests. A meta-analysis and post hoc sensitivity analyses were performed when possible.
RESULTS
Twenty-two studies (1202 patients with headache and 597 controls) were included in this review and 16 of them in the meta-analysis. Risk of bias ranged from low to moderate among all studies. Greater sway area in static posturography was shown by patients with migraine in comparison to controls, with more consistent differences in more challenging test conditions, such as over a foam surface with eyes closed (difference of 4.8 cm , 95% CI: 3.8-5.9). Lower performance of patients with migraine during the tandem walk test (difference of -7.8 cm/s, 95% CI: -9.0 to -6.5) and slower reaction time in the LOS test (difference of 0.3 s, 95% CI: 0.2-0.4) were also verified. There is no evidence of altered sway velocity and length in static posturography among patients with migraine (p > 0.05). The level of evidence is very low for balance alteration of any kind among patients with tension-type and cervicogenic headache owing to the limited number of studies and high heterogeneity.
CONCLUSION
This review confirmed the presence of static and dynamic balance alterations among patients with migraine. Future studies with low risk of bias are needed to decrease heterogeneity in methodology and explore the role of subdiagnosis on the balance of patients with headache.
Topics: Case-Control Studies; Headache; Humans; Migraine Disorders; Post-Traumatic Headache; Postural Balance
PubMed: 35315066
DOI: 10.1111/head.14281 -
Multiple Sclerosis and Related Disorders May 2024To look for any potential association of headache disorders with multiple sclerosis (MS). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To look for any potential association of headache disorders with multiple sclerosis (MS).
BACKGROUND
The prevalence of headache disorders has been found to be increased in people with MS (pwMS), however, an association has not been established. Existing studies have provided conflicting results mostly because of methodological differences.
METHODS
PubMed, Embase and Scopus were searched to identify eligible studies. Studies were included if they were cross-sectional, case-control or cohort. Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias of the included studies. Case-control, cross sectional or cohort studies that used the International Classification of Headache Disorders (ICHD)-2 or-3 criteria for headache diagnosis and Mc Donald or Poser criteria for MS diagnosis were included. Data were extracted using standardized data collection form. Meta-analysis was conducted by calculating the overall prevalence of headache disorders in pwMS as well as the association of headache disorders with MS. The Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of non-randomized studies, was used to assess the quality of the included studies.
RESULTS
Twenty-three studies were included yielding a total of 5,440 MS patients and 28,0958 controls. The majority of them scored a NOS score between 5 and 6 (max 9), which indicates that they did not rank high in terms of quality, because most studies were cross-sectional and uncontrolled, and only one was prospective, controlled, and longitudinal, but with small population size. Pooled prevalence for all headache disorders, migraine and tension-type headache (TTH) in pwMS was 58 % (95 % CI 0.54-0.61), 30 % (95 % CI 0.25-0.34) and 19 % (95 % CI 0.15-0.23) respectively. A significant association between migraine and MS was found (OR = 2.02, 95 % CI = 1.14-3.57).
CONCLUSION
PwMS are twice as likely to experience migraine as controls, but the results need to be translated with caution since most of the studies included in the meta-analysis were of low or moderate quality. Larger prospective cohort, controlled, longitudinal studies are needed to confirm whether there is indeed an association between MS and migraine.
Topics: Humans; Multiple Sclerosis; Headache Disorders; Comorbidity
PubMed: 38489946
DOI: 10.1016/j.msard.2024.105536 -
BMC Public Health Aug 2022Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China.
METHODS
PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test.
RESULTS
Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors.
CONCLUSION
The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life.
Topics: Female; Headache; Humans; Ischemic Stroke; Middle Aged; Prevalence; Quality of Life; Risk Factors; Stroke
PubMed: 35953857
DOI: 10.1186/s12889-022-13917-z