Non-Migraine Primary Headaches in Medicine: A Machine-Generated Overview of Current Research

380 Pages·2023·13.877 MB·English

by  Paolo Martelletti

Non-Migraine
Primary Headaches
in Medicine
A Machine-Generated
Overview of Current Research
Paolo Martelletti
Editor
123
Non-Migraine Primary Headaches in Medicine
Paolo Martelletti
Editor
Non-Migraine Primary
Headaches in Medicine
A Machine-Generated Overview of Current
Research
Editor
Paolo Martelletti
Department of Clinical and Molecular Medicine
Sapienza University of Rome
Rome, Italy
ISBN 978-3-031-20893-5 ISBN 978-3-031-20894-2 (eBook)
https://doi.org/10.1007/978-3-031-20894-2
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Preface
It is well established in all the international scientific literature that headache disor-
ders are among the most prevalent and disabling conditions worldwide. The Global
Burden of Diseases, gathering many important epidemiological studies, has con-
firmed the evidence of the high prevalence of tension-type headache, with a moder-
ate level of caused disability, and the low prevalence of trigeminal autonomic
cephalalgias which cause a very high disability, and the others non-migraine head-
ache disorders for their potential risk caused by an incorrect diagnostic definition
among primary and secondary forms.
The help of Artificial Intelligence in finding, capturing and structuring what the
most recent publications have highlighted in these non-migraine forms of primary
headache is the fundamental passage of this book.
It is aimed at all those who want to directly consult the original source of the
literature to make informed clinical decisions reaching the exact publication needed.
It is a new way of approaching the culture of headaches by skipping the interpreta-
tions and filters of the authors, providing everything that is necessary for a clinical
decision that is informed from a diagnostic and therapeutic point of view. The cor-
rectness of the original information will allow both the headache expert and any
clinician to reduce the diagnostic errors that can often lead to the risks of analgesics
abuse and delays, sometimes even life-threatening.
This volume, like the previous one on migraine, is dedicated to physicians facing
in their daily clinical practice the non-migraine headache forms, to PhD students, to
residents aiming to add value to the management of underestimated tension-type
headache, to improve the immediate definition of trigeminal autonomic cephalal-
gias and other non-migraine primary headache disorders.
Department of Clinical and Molecular Medicine Paolo Martelletti
Sapienza University of Rome
Rome, Italy
v
Contents
1 Tension-Type Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Trigeminal Autonomic Cephalalgias . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
3 Other Non-migraine Primary Headache Disorders . . . . . . . . . . . . . . . 321
vii
Chapter 1
Tension-Type Headache
1.1 Introduction
Tension-type headache is the second most common cause of chronic pain in the
Global Burden of Disease, affecting an estimated population of nearly 900 million
new cases per year. The estimated prevalence of tension-type headache is enormous,
with a very high variability from 10% up to 86% in young subjects. The global
prevalence of the chronic form is equally important because it covers about two 3%
of the global population. Despite such an important epidemiological economic
impact, tension-type headache causes less disability than migraine. In terms of
years of life lived with disabilities the comorbidities of tension-type headache are
often similar to those of migraine such as anxiety, depression, sleep disturbances
and other pain disorders including migraine itself. The physiopathology of the
tension- type headache is mainly based on genetic factors, myofascial mechanisms
and chronicization mechanisms such as sensitization, therefore peripheral mecha-
nisms and vascular factors are mostly unimportant. The central factors are important
in the transformation from the episodic form to the chronic one. Unfortunately, the
non-exact definition of the pathophysiology and the moderate burden impact and
even a modest economic impact has left the tension-type headache, from a therapeu-
tic point of view, still with old generation drugs, with no new compounds dedicated
to this pathology for many decades. However, being a pathology with a great impact
in the general population, it is useful to know the most important lines of research
and any updates also in the field of complementary medicine that can guide the
clinician in his/her daily practice.
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2023 1
P. Martelletti (ed.), Non-Migraine Primary Headaches in Medicine,
https://doi.org/10.1007/978-3-031-20894-2_1
2 P. Martelletti
1.2 Machine-Generated Summaries
Machine generated keywords: tth, migraine tth, tensiontype, tensiontype headache,
burden, child, gbd, country, global, sleep, manual, muscle, adolescent, tension, tth
migraine.
Public Health
Machine generated keywords: gbd, burden, global, country, burden disease, burden
headache, tth, adolescent, participant, migraine tth, epidemiological, global burden,
live disability, million, health.
The Global Prevalence of Headache: An Update, with Analysis
of the Influences of Methodological Factors
on Prevalence Estimates
DOI: https://doi.org/10.1186/s10194- 022- 01402- 2
Abstract-Summary
According to the Global Burden of Disease (GBD) study, headache disorders are
among the most prevalent and disabling conditions worldwide.
GBD builds on epidemiological studies (published and unpublished) which are
notable for wide variations in both their methodologies and their prevalence
estimates.
Our first aim was to update the documentation of headache epidemiological stud-
ies, summarizing global prevalence estimates for all headache, migraine, tension-
type headache (TTH) and headache on ≥15 days/month (H15+), comparing these
with GBD estimates and exploring time trends and geographical variations.
Our second aim was to analyse how methodological factors influenced preva-
lence estimates.
From 357 publications, the vast majority from high-income countries, the esti-
mated global prevalence of active headache disorder was 52.0% (95% CI 48.9–55.4),
of migraine 14.0% (12.9–15.2), of TTH 26.0% (22.7–29.5) and of H15+ 4.6%
(3.9–5.5).
Methodological factors contributing to variation, were publication year, sample
size, inclusion of probable diagnoses, sub-population sampling (e.g., of health-care
personnel), sampling method (random or not), screening question (neutral, or quali-
fied in severity or presumed cause) and scope of enquiry (headache disorders only
or multiple other conditions).
1 Tension-Type Headache 3
With these taken into account, migraine prevalence estimates increased over the
years, while estimates for all headache types varied between world regions.
The review confirms GBD in finding that headache disorders remain highly prev-
alent worldwide, and it identifies methodological factors explaining some of the
large variation between study findings.
These variations render uncertain both the increase in migraine prevalence esti-
mates over time, and the geographical differences.
Extended:
Future studies should not assess prevalence alone but include data allowing TIS
to be estimated, preferably among the various age and gender subgroups.
Introduction
Through the Global Burden of Disease (GBD) study, headache disorders are
revealed as one of the major public-health concerns globally and in all countries and
world regions [1].
For the various disorders it considers, GBD uses multiple data sources (epide-
miological studies, health registers, official statistics, hospital data, etc.) to make
best-informed estimates of prevalence and burden.
They included criteria for judging the quality of studies from their reported
methodology, and some adjustments to prevalence estimates were based upon these
in the most detailed analysis of headache data, from GBD 2016 [1].
We reviewed all published studies of the prevalence and burden of headache [2].
We update that review, and the documentation of headache epidemiological stud-
ies, summarizing global prevalence estimates for headache, migraine, tension-type
headache (TTH) and headache on ≥15 days/month (H15+), comparing these with
GBD estimates and exploring time trends and geographical variations.
Methods
To geographical origin and publication year, we extracted data related to the quality
criteria [3]: those describing the population of interest (the general population or a
specified sub-population), sampling method (randomness and representativeness),
size of sample, participating proportion, methods of data collection (access to and
engagement with participants) and validation of diagnostic questions.
For MLR analyses we dichotomized the quality measures [3] that were not inter-
val or ordinal variables: population of interest (unselected [general] population of a
country, community or tribe, or pupils of obligatory schools, versus selected sub-
populations [e.g., university students, factory/workplace employees, minorities, etc.],
or unstipulated [additionally, we registered whether selected subpopulations were
health-care personnel such as medical students, hospital employees, neurologists,
etc.]); sample representativeness of the population of interest (random sampling ver-
sus non-random sampling or failed attempt to secure randomness); access to and
engagement with participants (face-to-face or telephone interview versus unsuper-
vised questionnaire completion or unstipulated); validation of diagnostic questions
(effort at validating versus none or unstipulated); application of ICHD criteria and
distinction between definite and probable diagnoses versus not or unstipulated.
4 P. Martelletti
Results
Studies with mid-range age values below 10 or above 65 years reported lower
migraine prevalences in both males and females, and studies with values below
10 years reported lower TTH prevalences in both genders.
In studies estimating prevalences of an active headache disorder and of specific
headache types, there were clear positive correlations between them: for headache
with migraine (r = 0.46, p < 0.01, 142 studies), with TTH (r = 0.48, p < 0.01, 84
studies) and with H15+ (r = 0.45, p < 0.01, 42 studies), for migraine with TTH
(0.36, p < 0.0000, 105 studies) and with H15+ (0.45, p < 0.01, 43 studies), and for
TTH with H15+ (0.37, p = 0.2, 43 studies).
Discussion
It is uncertain whether or to what extent these differences over time and place are
real: overall, the MLR analyses show that the present models explain relatively little
of the large variations in prevalence estimates between studies (for migraine less
than 30%, and even less for other headache types, possibly because of fewer studies).
In the MLR analyses, publication year appeared important as a factor explaining
variation in migraine prevalence estimates (6.4% of variation in Model 2, higher
estimates associated with more recent publication), but it played no role in other
headache types.
The negative association of prevalence estimates of all headache, migraine and
H15+ with number of study participants (Model 2: 3.2%, 1.6% and 12.5% of varia-
tions respectively) may indicate that smaller studies can afford more sensitive meth-
ods (personal interview, face to face or by phone) to detect cases.
Conclusions
While this review updates our earlier documentation of headache epidemiological
studies [2], it also highlights the dependence of prevalence estimates on a small
number of methodological factors (and relative independence of others that might
be expected to be influential).
Future prevalence estimates from all parts of the world will be derived from stud-
ies performed in a relatively standardized way, in accordance with published
recommendations.
Future studies should not assess prevalence alone but include data allowing TIS
to be estimated, preferably among the various age and gender subgroups.
Acknowledgement
A machine generated summary based on the work of Stovner, Lars Jacob; Hagen,
Knut; Linde, Mattias; Steiner, Timothy J. 2022 in The Journal of Headache and Pain.