Comorbidities of primary headache disorders: a literature review with meta-analysis

The Journal of Headache and Pain

Micaela Robotti¹  Gioacchino De Vanna²  Daniele Martinelli³  Paolo Martelletti⁴  Manuela Deodato⁵  Gleni Halili⁶  Irene Tramacere⁷  Emanuela Fellini⁸  Serena Serratore⁸  Gabriele Nalli⁸  Valeria Pozzilli⁸  Eleonora De Matteis⁹  Valeria Caponnetto^1,10  Maria Koutsokera^1,11  Giovanna Nocera^1,12  Cristina Galati^1,12  Alberto Raggi^1,13 

[1] Centro di Diagnosi e Cura delle Cefalee, Palazzo della Salute, Gruppo San Donato, Milano, Italy;PainClinicMilano, Centro Medico Visconti di Modrone, Milano, Italy;Clinica Neurologica, Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italy;Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy;Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy;Department of Clinical and Molecular Medicine, Sapienza University, Roma, Italy;Regional Referral Headache Center, Sant’Andrea University Hospital, Roma, Italy;Department of Life Sciences, University of Trieste, Trieste, Italy;Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy;Department of Neurology, University Hospital Center ‘Mother Teresa’, Tirana, Albania;Dipartimento di Ricerca e Sviluppo Clinico, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy;Internal Medicine Unit, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy;Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy;SS Filippo & Nicola Hospital, University of L’Aquila, Avezzano, Italy;Thriassio General Hospital of Elefsina, Elefsina, Greece;UO Neuropsichiatria Infantile, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy;UOC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy;

关键词: Primary headache;    Migraine;    TTH;    CH;    Comorbidity;    Depression;    Obesity;    Diabetes;    Hypertension;    Stroke;    Sleep disorders;   

DOI  :  10.1186/s10194-021-01281-z

来源: Springer

【 摘 要 】

BackgroundPrimary headache disorders are common and burdensome conditions. They are associated to several comorbidities, such as cardiovascular or psychiatric ones, which, in turn, contribute to the global burden of headache. The aim of this study is to provide a comprehensive description of the pooled prevalence of comorbidities of primary headache disorders using a meta-analytical approach based on studies published between 2000 and 2020.MethodsScopus was searched for primary research (clinical and population studies) in which medical comorbidities were described in adults with primary headache disorders. Comorbidities were extracted using a taxonomy derived from the Global Burden of Disease (GBD) study. We compared prevalence of comorbidities among headache sufferers against general population using GBD-2019 estimates, and compared comorbidities’ proportions in clinical vs. population studies, and by age and gender.ResultsA total of 139 studies reporting information on 4.19 million subjects with primary headaches were included: in total 2.75 million comorbidities were reported (median per subject 0.64, interquartile range 0.32–1.07). The most frequently addressed comorbidities were: depressive disorders, addressed in 51 studies (pooled proportion 23 %, 95 % CI 20–26 %); hypertension, addressed in 48 studies (pooled proportion 24 %, 95 % CI 22–26 %); anxiety disorders addressed in 40 studies (pooled proportion 25 %, 95 % CI 22–28 %). For conditions such as anxiety, depression and back pain, prevalence among headache sufferers was higher than in GBD-2109 estimates. Associations with average age and female prevalence within studies showed that hypertension was more frequent in studies with higher age and less females, whereas fibromyalgia, restless leg syndrome, and depressive disorders were more frequent in studies with younger age and more female.ConclusionsSome of the most relevant comorbidities of primary headache disorders – back pain, anxiety and depression, diabetes, ischemic heart disease and stroke – are among the most burdensome conditions, together with headache themselves, according to the GBD study. A joint treatment of headaches and of these comorbidities may positively impact on headache sufferers’ health status and contribute to reduce the impact of a group of highly burdensome diseases.

【 授权许可】

CC BY