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Influence of chronotype on migraine characteristics

  • Giovanna ViticchiEmail author
  • Lorenzo Falsetti
  • Matteo Paolucci
  • Claudia Altamura
  • Laura Buratti
  • Sergio Salvemini
  • Nicoletta Brunelli
  • Marco Bartolini
  • Fabrizio Vernieri
  • Mauro Silvestrini
Original Article
  • 38 Downloads

Abstract

Background

The aim of this study was to investigate chronotype in migraine patients and possible influences on the clinical expression of the disease.

Methods

During a one-year period, all consecutive patients admitted to two third-level headache centres with a new diagnosis of migraine were enrolled in a cross-sectional study. All subjects were submitted to the Morningness–Eveningness Questionnaire (MEQ-SA) and then classified in five different categories, from late to early-rising chronotype. Differences and trends among MEQ-SA categories and years from migraine onset, attacks’ intensity and frequency were analysed first with analysis of variance, then with a multivariate/generalized linear model.

Results

One hundred seventy one migraine patients were included. Early-rising patients showed a lower migraine attacks frequency and longer disease duration with respect to late-rising patients. The categorical variable containing the five circadian types was able to identify a significantly different trend both for the monthly attacks frequency and for the disease duration (p < 0.0001 and p < 0.0001, respectively, analysis of variance). The results were also confirmed after correction for main influencing variables (multivariate/generalized linear model). The intensity of migraine attacks was not influenced by chronotype.

Conclusions

According to the results of the present study, chronotype seems to influence number and duration of migraine attacks. Although sleep–wake cycle is a well-recognized factor able to influence thalamic–cortical synchronization, it usually does not receive appropriate consideration during migraine patients’ assessment.

Keywords

Headache Sleep–wake cycle Circadian rhythm Sleep 

Notes

Compliance with ethical standards

The ethics committees of Marche Polytechnic University and Campus Bio-Medico University of Rome approved the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Golombek DA, Rosenstein RE (2010) Physiology of circadian entrainment. Physiol Rev 90(3):1063–1102.  https://doi.org/10.1152/physrev.00009.2009 CrossRefGoogle Scholar
  2. 2.
    Zee PC, Attarian H, Videnovic A (2013) Circadian rhythm abnormalities. Continuum (Minneap Minn) 19(1):132–147.  https://doi.org/10.1212/01.CON.0000427209.21177.aa Google Scholar
  3. 3.
    Videnovic A, Lazar AS, Barker RA, Overeem S (2014) ‘The clocks that time us’--circadian rhythms in neurodegenerative disorders. Nat Rev Neurol 10(12):683–693.  https://doi.org/10.1038/nrneurol.2014.206 CrossRefGoogle Scholar
  4. 4.
    Grandin LD, Alloy LB, Abramson LY (2006) The social zeitgeber theory, circadian rhythms, and mood disorders: review and evaluation. Clin Psychol Rev 26:679–694.  https://doi.org/10.1016/j.cpr.2006.07.001 CrossRefGoogle Scholar
  5. 5.
    Vgontzas A, Cui L, Merikangas KR (2008) Are sleep difficulties associated with migraine attributable to anxiety and depression? Headache 48(10):1451–1459.  https://doi.org/10.1111/j.1526-4610.2008.01175.x CrossRefGoogle Scholar
  6. 6.
    Burish MJ, Chen Z, Yoo SH (2018) Emerging relevance of circadian rhythms in headaches and neuropathic pain. Acta Physiol (Oxf) 3:e13161Google Scholar
  7. 7.
    Headache Classification Committee of the International Headache Society (IHS) (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33(9):629–808.  https://doi.org/10.1177/0333102413485658 CrossRefGoogle Scholar
  8. 8.
    Beck AT, Steer RA, Ball R, Ranieri WF (1996) Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess 67(3):588–597.  https://doi.org/10.1207/s15327752jpa6703_13 CrossRefGoogle Scholar
  9. 9.
    Cavallera GM, Boari G (2015) Validation of the Italian Version of the Morningness-Eveningness Questionnaire for adolescents by A. Lancry and Th. Arbault. Med Sci Monit 10(21):2685–2693.  https://doi.org/10.12659/MSM.894091 CrossRefGoogle Scholar
  10. 10.
    Horne J, Östberg O (1976) A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 4:97–110Google Scholar
  11. 11.
    Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S, European Palliative Care Research Collaborative (EPCRC) (2011) Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manag 41(6):1073–1093.  https://doi.org/10.1016/j.jpainsymman.2010.08.016 CrossRefGoogle Scholar
  12. 12.
    Tonetti L, Fabbri M, Filardi M, Martoni M, Natale V (2015) Effects of sleep timing, sleep quality and sleep duration on school achievement in adolescents. Sleep Med 16:936–940.  https://doi.org/10.1016/j.sleep.2015.03.026 CrossRefGoogle Scholar
  13. 13.
    Viticchi G, Silvestrini M, Falsetti L, Lanciotti C, Cerqua R, Luzzi S, Provinciali L, Bartolini M (2011) Time delay from onset to diagnosis of migraine. Headache 51(2):232–236.  https://doi.org/10.1111/j.1526-4610.2010.01778.x CrossRefGoogle Scholar
  14. 14.
    Smolensky MH, Portaluppi F, Manfredini R, Hermida RC, Tiseo R, Sackett-Lundeen LL, Haus EL (2015) Diurnal and twenty-four hour patterning of human diseases: acute and chronic common and uncommon medical conditions. Sleep Med Rev 21:12–22.  https://doi.org/10.1016/j.smrv.2014.06.005 CrossRefGoogle Scholar
  15. 15.
    Harper DG, Stopa EG, McKee AC et al (2004) Dementia severity and Lewy bodies affect circadian rhythms in Alzheimer disease. Neurobiol Aging 25:771–781.  https://doi.org/10.1016/j.neurobiolaging.2003.04.009 CrossRefGoogle Scholar
  16. 16.
    Verbaan D, van Rooden SM, Visser M, Marinus J, van Hilten JJ (2008) Nighttime sleep problems and daytime sleepiness in Parkinson’s disease. Mov Disord 23:35–41.  https://doi.org/10.1002/mds.21727 CrossRefGoogle Scholar
  17. 17.
    Vernieri F, Tibuzzi F, Pasqualetti P, Altamura C, Palazzo P, Rossini PM, Silvestrini M (2008) Increased cerebral vasomotor reactivity in migraine with aura: an autoregulation disorder? A transcranial Doppler and near-infrared spectroscopy study. Cephalalgia 28:689–695.  https://doi.org/10.1111/j.1468-2982.2008.01579.x CrossRefGoogle Scholar
  18. 18.
    Hale JR, White TP, Mayhew SD, Wilson RS, Rollings DT, Khalsa S, Arvanitis TN, Bagshaw AP (2016) Altered thalamocortical and intra-thalamic functional connectivity during light sleep compared with wake. Neuroimage 125:657–667.  https://doi.org/10.1016/j.neuroimage.2015.10.041 CrossRefGoogle Scholar
  19. 19.
    May A (2017) Understanding migraine as a cycling brain syndrome: reviewing the evidence from functional imaging. Neurol Sci 38(Suppl 1):125–130.  https://doi.org/10.1007/s10072-017-2866-0 CrossRefGoogle Scholar
  20. 20.
    de Tommaso M, Ambrosini A, Brighina F, Coppola G, Perrotta A, Pierelli F, Sandrini G, Valeriani M, Marinazzo D, Stramaglia S, Schoenen J (2014) Altered processing of sensory stimuli in patients with migraine. Nat Rev Neurol 10(3):144–155.  https://doi.org/10.1038/nrneurol.2014.14 CrossRefGoogle Scholar
  21. 21.
    de Tommaso M, Stramaglia S, Marinazzo D, Trotta G, Pellicoro M (2013) Functional and effective connectivity in EEG alpha and beta bands during intermittent flash stimulation in migraine with and without aura. Cephalalgia 33(11):938–947.  https://doi.org/10.1177/0333102413477741 CrossRefGoogle Scholar
  22. 22.
    Singh NN, Sahota P (2013) Sleep-related headache and its management. Curr Treat Options Neurol 15(6):704–722.  https://doi.org/10.1007/s11940-013-0258-1 CrossRefGoogle Scholar
  23. 23.
    Kelman L (2006) Pain characteristics of the acute migraine attack. Headache 46(6):942–953.  https://doi.org/10.1111/j.1526-4610.2006.00443.x CrossRefGoogle Scholar
  24. 24.
    Kelman L (2007) The triggers or precipitants of the acute migraine attack. Cephalalgia 27(5):394–402.  https://doi.org/10.1111/j.1468-2982.2007.01303.x CrossRefGoogle Scholar
  25. 25.
    Rains JC, Poceta JS (2006) Headache and sleep disorders: review and clinical implications for headache management. Headache 46(9):1344–1363.  https://doi.org/10.1111/j.1526-4610.2006.00578.x CrossRefGoogle Scholar
  26. 26.
    Viticchi G, Falsetti L, Bartolini M et al (2018) Migraine: incorrect self-management for a disabling disease. Neurol Int 10(1):7510.  https://doi.org/10.4081/ni.2018.7510 CrossRefGoogle Scholar
  27. 27.
    Yang X, Liu B, Yang B, Li S, Wang F, Li K, Hu F, Ren H, Xu Z (2018) Prevalence of restless legs syndrome in individuals with migraine: a systematic review and meta-analysis of observational studies. Neurol Sci 39(11):1927–1934.  https://doi.org/10.1007/s10072-018-3527-7 CrossRefGoogle Scholar
  28. 28.
    Akdag Uzun Z, Kurt S, Karaer Unaldi H (2018) The relationship with restless legs syndrome, fibromyalgia, and depressive symptoms in migraine patients. Neurol Sci 39(8):1409–1414.  https://doi.org/10.1007/s10072-018-3438-7 CrossRefGoogle Scholar
  29. 29.
    Schulte LH, May A (2016) The migraine generator revisited: continuous scanning of the migraine cycle over 30 days and three spontaneous attacks. Brain 139:1987–1993.  https://doi.org/10.1093/brain/aww097 CrossRefGoogle Scholar
  30. 30.
    Cevoli S, Nicodemo M, Grimaldi D, Leonardi L, Montagna P, Cortelli P, Pierangeli G (2010) Chronotypes in menstrual migraine: a case-control study. Neurol Sci 31(Suppl 1):S163–S164.  https://doi.org/10.1007/s10072-010-0315-4 CrossRefGoogle Scholar
  31. 31.
    Hofstra WA, van der Palen J, deWeerd AW (2012) Morningness and eveningness: when do patients take their antiepileptic drugs? Epilepsy Behav 23:320–323.  https://doi.org/10.1016/j.yebeh.2011.12.008 CrossRefGoogle Scholar
  32. 32.
    Manni R, Cremascoli R, De Icco R et al (2015) Chronotype in patients with epilepsy: a controlled study in 60 subjects with late-onset focal epilepsy. Epilepsy Behav 50:1–6.  https://doi.org/10.1016/j.yebeh.2015.05.031 CrossRefGoogle Scholar
  33. 33.
    Masruha MR, Lin J, de Souza Vieira DS, Minett TSC, Cipolla-Neto J, Zukerman E, Vilanova LCP, Peres MFP (2010) Urinary 6-sulphatoxymelatonin levels are depressed in chronic migraine and several comorbidities. Headache 50(3):413–419.  https://doi.org/10.1111/j.1526-4610.2009.01547.x CrossRefGoogle Scholar
  34. 34.
    Gelfand A, Goadsby PJ (2016) The role of melatonin in the treatment of primary headache disorders. Headache 56(8):1257–1266.  https://doi.org/10.1111/head.12862 CrossRefGoogle Scholar
  35. 35.
    Masruha MR, de Souza Vieira DS, Minett TS et al (2008) Low urinary 6-sulphatoxymelatonin concentrations in acute migraine. J Headache Pain 9(4):221–224.  https://doi.org/10.1007/s10194-008-0047-5 CrossRefGoogle Scholar

Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  • Giovanna Viticchi
    • 1
    Email author
  • Lorenzo Falsetti
    • 2
  • Matteo Paolucci
    • 3
  • Claudia Altamura
    • 3
  • Laura Buratti
    • 1
  • Sergio Salvemini
    • 1
  • Nicoletta Brunelli
    • 3
  • Marco Bartolini
    • 1
  • Fabrizio Vernieri
    • 3
  • Mauro Silvestrini
    • 1
  1. 1.Neurological ClinicMarche Polytechnic UniversityAnconaItaly
  2. 2.Internal and Subintensive Medicine, Ospedali RiunitiAnconaItaly
  3. 3.Neurology UnitCampus Bio-Medico UniversityRomeItaly

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