Fibromyalgia may be a clinical sign of more severe headaches in patients with migraine, and more frequently affects those with chronic migraines or migraines with aura, which are accompanied by neurological symptoms, a study has found.
The research, “Comorbid fibromyalgia in migraine patients: clinical significance and impact on daily life,” was published in the journal Neurological Research.
People with fibromyalgia (FM) frequently experience headaches, a problem that reportedly affects about half those patients. The presence of both conditions has been associated with increased headache frequency, muscle tenderness in the head, anxiety, and sleep inadequacy.
In addition to pain complaints, people with fibromyalgia and chronic headaches share co-occurrence of similar psychological disorders, which has led to theories that both conditions may share similar physiological (body function) alterations, too.
But there is controversy over the impact and the prognostic value of FM in migraine, and the relationship between these entities.
In this study, a team led by researchers at Yozgat City Hospital, Turkey, investigated the impact of FM in patients with migraine to find specific features characteristic of this group of patients, as compared to those without FM.
The study enrolled 102 people with migraine, ages 18 to 50, 85.3% of whom were women. Participants were asked to complete self-report questionnaires assessing pain- or migraine-related disability, anxiety, depression, sleep disturbance, and quality of life.
A great majority of the patients (92%) were diagnosed with episodic migraine (defined as less than 15 headache days per month) whereas 8% of them had chronic migraine (defined as more than 15 headache days per month) over a three-month period, in the absence of medication.
Overall, simultaneous (comorbid) fibromyalgia was detected in 30.3% of the patients. However, researchers noted that FM was more prominent in people with chronic migraines and those having migraines with aura, that is, people who experience headaches associated with neurological symptoms, most commonly visual disturbances.
Even though the association of FM and migraine with aura has been controversial, with conflicting evidence, researchers think the possible association between both warrants further investigation in larger studies.
Comparisons between patients with and without FM revealed that headache frequency, migraine disease duration, headache impact test and disability — assessed by Migraine Disability Assessment Score (MIDAS) — were higher in patients with FM.
Moreover, FM was associated with a poorer vitality and role limitations due to emotional problems, which might be related to more severe migraines and the added burden of FM symptoms.
“The results of our study may suggest the presence of FM as a clinical sign of a more severe migraine,” researchers wrote.
“The significance of our study was that we conducted the analyses of the possible effect of FM by multiple statistical methods which all confirmed the association, making the results more reliable,” they added.
“However, the long-term prospective studies including these group of patients are needed to understand the prognostic impact and importance of the comorbid FM in migraine,” they stressed.
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