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Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study
BACKGROUND: Pharmacological treatment of patients with tension-type headache (TTH) includes symptomatic (acute) and prophylactic (preventive) medication. No previous study has investigated variables associated to symptomatic medication intake in TTH. Our aim was to assess the association of clinical...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995039/ https://www.ncbi.nlm.nih.gov/pubmed/32007103 http://dx.doi.org/10.1186/s12883-020-1624-8 |
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author | Fernández-de-las-Peñas, César Palacios-Ceña, Maria Castaldo, Matteo Wang, Kelun Guerrero-Peral, Ángel Catena, Antonella Arendt-Nielsen, Lars |
author_facet | Fernández-de-las-Peñas, César Palacios-Ceña, Maria Castaldo, Matteo Wang, Kelun Guerrero-Peral, Ángel Catena, Antonella Arendt-Nielsen, Lars |
author_sort | Fernández-de-las-Peñas, César |
collection | PubMed |
description | BACKGROUND: Pharmacological treatment of patients with tension-type headache (TTH) includes symptomatic (acute) and prophylactic (preventive) medication. No previous study has investigated variables associated to symptomatic medication intake in TTH. Our aim was to assess the association of clinical, psychological and neurophysiological outcomes with the use and timing of the use of symptomatic medication in TTH. METHODS: A longitudinal observational study was conducted. One hundred and sixty-eight (n = 168) patients with TTH participated. Pain features of the headache (intensity, frequency, duration), burden of headache (Headache Disability Inventory), sleep quality (Pittsburgh Sleep Quality Index), anxiety/depression (Hospital Anxiety and Depression Scale), trait/state anxiety levels (State-Trait Anxiety Inventory), and bilateral pressure pain thresholds on the temporalis, C5-C6 joint, second metacarpal and tibialis anterior were assessed. Symptomatic medication intake was also collected for a 6-months follow-up period. Differences between patients using or not using symptomatic medication, depending on self-perceived effectiveness, and time (early during an attack, i.e., the first 5 min, or when headache attack is intense) when the symptomatic medication was taken were calculated. RESULTS: One hundred and thirty-six (n = 136, 80%) reported symptomatic medication intake for headache (73% NSAIDs). Sixteen (12%) reported no pain relief, 81 (59%) experienced moderate relief and 39 (29%) total pain relief. Fifty-eight (43%) took ‘early medication’ whereas 78 (57%) took ‘late medication’. Patients taking symptomatic medication in general showed lower headache frequency and lower depressive levels than those patients not taking medication. Symptomatic medication was more effective in patients with lower headache history, frequency, and duration, and lower emotional burden. No differences in pressure pain sensitivity were found depending on the self-perceived effectiveness of medication. Patients taking ‘late symptomatic’ medication exhibited more widespread pressure pain sensitivity than those taking ‘early medication’. CONCLUSIONS: This study found that the effectiveness of symptomatic medication was associated with better headache parameters (history, frequency, or duration) and lower emotional burden. Further, consuming early symptomatic medication at the beginning of a headache attack (the first 5 min) could limit widespread pressure pain sensitivity. |
format | Online Article Text |
id | pubmed-6995039 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69950392020-02-04 Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study Fernández-de-las-Peñas, César Palacios-Ceña, Maria Castaldo, Matteo Wang, Kelun Guerrero-Peral, Ángel Catena, Antonella Arendt-Nielsen, Lars BMC Neurol Research Article BACKGROUND: Pharmacological treatment of patients with tension-type headache (TTH) includes symptomatic (acute) and prophylactic (preventive) medication. No previous study has investigated variables associated to symptomatic medication intake in TTH. Our aim was to assess the association of clinical, psychological and neurophysiological outcomes with the use and timing of the use of symptomatic medication in TTH. METHODS: A longitudinal observational study was conducted. One hundred and sixty-eight (n = 168) patients with TTH participated. Pain features of the headache (intensity, frequency, duration), burden of headache (Headache Disability Inventory), sleep quality (Pittsburgh Sleep Quality Index), anxiety/depression (Hospital Anxiety and Depression Scale), trait/state anxiety levels (State-Trait Anxiety Inventory), and bilateral pressure pain thresholds on the temporalis, C5-C6 joint, second metacarpal and tibialis anterior were assessed. Symptomatic medication intake was also collected for a 6-months follow-up period. Differences between patients using or not using symptomatic medication, depending on self-perceived effectiveness, and time (early during an attack, i.e., the first 5 min, or when headache attack is intense) when the symptomatic medication was taken were calculated. RESULTS: One hundred and thirty-six (n = 136, 80%) reported symptomatic medication intake for headache (73% NSAIDs). Sixteen (12%) reported no pain relief, 81 (59%) experienced moderate relief and 39 (29%) total pain relief. Fifty-eight (43%) took ‘early medication’ whereas 78 (57%) took ‘late medication’. Patients taking symptomatic medication in general showed lower headache frequency and lower depressive levels than those patients not taking medication. Symptomatic medication was more effective in patients with lower headache history, frequency, and duration, and lower emotional burden. No differences in pressure pain sensitivity were found depending on the self-perceived effectiveness of medication. Patients taking ‘late symptomatic’ medication exhibited more widespread pressure pain sensitivity than those taking ‘early medication’. CONCLUSIONS: This study found that the effectiveness of symptomatic medication was associated with better headache parameters (history, frequency, or duration) and lower emotional burden. Further, consuming early symptomatic medication at the beginning of a headache attack (the first 5 min) could limit widespread pressure pain sensitivity. BioMed Central 2020-02-01 /pmc/articles/PMC6995039/ /pubmed/32007103 http://dx.doi.org/10.1186/s12883-020-1624-8 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Fernández-de-las-Peñas, César Palacios-Ceña, Maria Castaldo, Matteo Wang, Kelun Guerrero-Peral, Ángel Catena, Antonella Arendt-Nielsen, Lars Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title | Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title_full | Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title_fullStr | Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title_full_unstemmed | Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title_short | Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study |
title_sort | variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a european study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995039/ https://www.ncbi.nlm.nih.gov/pubmed/32007103 http://dx.doi.org/10.1186/s12883-020-1624-8 |
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