Chronic Migraine: Epidemiology and Disease Burden
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Chronic migraine is a common and disabling complication of migraine with a population prevalence of about 2%. Emerging evidence suggests that episodic migraine and chronic migraine differ not only in degree, but also in kind. Compared with patients with episodic migraine, those with chronic migraine have worse socioeconomic status, reduced health-related quality of life, increased headache-related burden (including impairment in occupational, social, and family functioning), and greater psychiatric and medical comorbidities. Each year, approximately 2.5% of patients with episodic migraine develop new-onset chronic migraine (ie, chronification). Understanding the natural disease course, improving treatment and management, and preventing the onset could reduce the enormous individual and societal burden of chronic migraine, and thus, have become important goals of headache research. This review provides a summary of the history of nomenclature and diagnostic criteria, as well as recent studies focusing on the epidemiology, natural history, and burden of chronic migraine.
KeywordsChronic migraine Episodic migraine Epidemiology Burden Prevalence Natural history Comorbidities Health-related quality of life Resource utilization Headache impact
Dr. Aubrey N. Manack is a full-time employee of Allergan, Inc. Dr. Dawn C. Buse has served as a consultant to Allergan, and has received grants or has grants pending with Allergan, Merck Pharmaceuticals, Endo Pharmaceuticals, OrthoMcNeil Pharmaceuticals, and GlaxoSmithKline. Dr. Richard B. Lipton is a member of the advisory boards of Allergan, Merck, and MAP Pharmaceuticals, Inc.; has served as a consultant for Allergan; has received grants or has grants pending with Allergan, Merck Pharmaceuticals, GlaxoSmithKline, and Bristol-Myers Squibb; has received payment for manuscript preparation from Allergan; has received payment for the development of educational presentations from Allergan; and has received travel expense compensation from Allergan and Merck.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 11.•• Buse DC, Manack A, Serrano D, Turkel C, Lipton RB: Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers. J Neurol Neurosurg Psychiatry 2010, 81:428–432. This article provides new evidence regarding the sociodemographic and comorbidity profile associated with chronic migraine. Anxiety, depression, nonheadache chronic pain disorders, respiratory disorders including asthma, bronchitis and chronic obstructive pulmonary disease, and cardiac risk factors including hypertension, diabetes, high cholesterol, and obesity all were significantly more likely to be reported by patients with chronic migraine than by those with episodic migraine. Google Scholar
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- 38.Ashina S, Buse DC, Manack AN, Serrano D, Maizels M, Turkel C, Lipton RB. Depression: a risk factor for migraine chronification: results from the American Migraine Prevalence and Prevention (AMPP) Study. Neurology 74(Suppl 2):A113, 2010. Presented at the Annual Meeting of the American Academy of Neurology, April 13, 2010.Google Scholar
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- 49.•• Munakata J, Hazard E, Serrano D, Klingman D, Rupnow MF, Tierce J, Reed M, Lipton RB: Economic burden of transformed migraine: Results from the American Migraine Prevalence and Prevention (AMPP) study. Headache 2009, 49:498–508. This article highlights the economic burden that chronic migraine imposes on society in the United States.Google Scholar