Profiling the real-world migraine patient: public health insights from sociodemographic, lifestyle, and clinical data in the Italian National Migraine Registry (I-GRAINE).
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Barbanti Piero, Fiorentini Giulia, Camarda Cecilia, Autunno Massimo, Pistoia Francesca, Aurilia Cinzia, d'Onofrio Florindo, Egeo Gabriella, Carnevale Antonio, Caproni Stefano, Doretti Alberto, Cherchi Alessandra, De Simone Roberto, Zucco Maurizio, Rinalduzzi Steno, Colombo Bruno, Filippi Massimo, Quintana Simone, Russo Marco, Coppola Alfonso, Grugno Rosario, Bartolini Marco, Viticchi Giovanna, Rao Renata, Albanese Maria, Vernieri Fabrizio, Grazzi Licia, Robotti Micaela, Di Summa Alfonsina, Aguggia Marco, Di Poggio Monica Laura Bandettini, Finocchi Cinzia, Terlizzi Rossana, Sansone Mattia, Gragnani Francesca, Querzani Pietro, Perini Francesco, Solla Paolo, Favoni Valentina, Ferrau Ludovica, Saporito Gennaro, Iannaccone Elisabetta, Colosimo Carlo, Messina Stefano, Di Clemente Laura, Cortese Francesca, Scatena Paola, Cosenza Domenico, Brunelli Nicoletta, Querzola Giacomo, Gai Annalisa, Cazzulo Sara, Tazza Francesco, Guarinoni Martina, Ercoli Tommaso, Tavani Sofia, Orlando Bianca, Bono Francesco, Bruno Pietro Antonio, Proietti Stefania, Bonassi Stefano, Tomino Carlo, Porreca Annamaria, Torelli Paola, Cevoli Sabina, Italian Migraine Registry (I-GRAINE) study group
Аннотация
METHODS: I-GRAINE is an ongoing, nationwide, multicenter, prospective registry involving 43 publicly funded headache centers. Since 19/04/2021, patients diagnosed with episodic migraine (EM) or chronic migraine (CM) have been systematically enrolled. Data were collected through face-to-face interviews conducted by trained neurologists using a dedicated electronic platform. Information included sociodemographic and lifestyle factors, comorbidities, and detailed clinical characteristics. We aimed to define the patient profile, explore the broad clinical phenotype, and compare EM and CM subgroups.
RESULTS: As of 02/05/2025, 1,630 patients had been enrolled (81.7% EM, 18.3% CM), predominantly female (85.4%), mean age 45.7 years, normal BMI (23.2 kg/m2), and high education level. Over 70% were physically inactive, and 32.2% reported sleep disturbances. Headache was typically unilateral (69.1%), pulsating (64.0%), and lasted > 24 h (57.1%). Frequently reported non-ICHD-3 symptoms included osmophobia (41.5%), allodynia (40.5%), dopaminergic symptoms (37.2%), cephalalgiaphobia (34.0%), and dizziness (16.9%). ≥ 1 comorbidity was present in 41.2% of patients. Compared to those with EM, CM patients had higher BMI (24.0 vs. 23.0, p < 0.001), greater sleep disturbances (39.1% vs. 30.6%, p = 0.006), earlier onset (16.5 vs. 17.7 years, p = 0.032), more severe pain (NRS: 8.1 vs. 7.5, p < 0.001), and higher prevalence of medication overuse (58.3% vs. 14.5%, p < 0.001), dopaminergic symptoms (45.1% vs. 35.4%, p = 0.002), allodynia (47.5% vs. 38.9%, p = 0.009), and cephalalgiaphobia (41.4% vs. 32.3%, p = 0.004). Disability was also greater (MIDAS: 76.3 vs. 41.9; HIT-6: 64.3 vs. 61.2; both p < 0.001).
CONCLUSIONS: The typical patient attending Italian headache centers is a 45-year-old, normal-weight, well-educated, employed woman, often physically inactive, affected by sleep disturbances, and experiencing an average of 9.8 migraine days/month. I-GRAINE identifies migraine symptoms that may represent endophenotypes and distinct patterns associated with CM, offering valuable real-world insights to inform personalized care, research, and health policy.