Pain medicine (Malden, Mass.) · 2026
Beyond headache: non-cephalic pain, fatigue, and post-traumatic stress symptoms as longitudinal predictors of chronic migraine outcomes.
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Sturgeon John A, Vest Noel, Barad Meredith, Darnall Beth, Mackey Sean
Аннотация
OBJECTIVE: Chronic migraine (CM) is a condition marked by highly frequent, intense, and disabling headaches. However, less commonly examined symptoms, such as persistent fatigue, widespread non-cephalic pain, and post-traumatic stress disorder, may also play a key role in migraine-relevant clinical outcomes.
METHODS: The current study utilized retrospective clinical registry data from 704 treatment-seeking patients with CM to examine longitudinal trajectories of pain intensity and pain-related life interference using linear growth modeling.
RESULTS: High levels of co-occurring non-cephalic pain (71.9% of patients) were noted in this sample. Patients endorsing more widespread pain reported higher average levels of pain intensity over time (β = 0.189 [0.103-0.275], P < .001) and less improvement in pain interference over time (β = 0.328 [0.131-0.525], P = .001). Additional findings included greater reductions in pain interference among patients with higher baseline levels of pain intensity (β = -0.185 [-0.351 to -0.020], P = .028) and fatigue (β = -0.280 [-0.493 to -0.067], P = .010) and non-significant associations between post-traumatic stress symptoms and pain intensity and pain interference in all models.
CONCLUSIONS: The current findings suggest that clinical factors sometimes overlooked in headache research, such as co-occurring non-cephalic pain and fatigue, may contribute to trajectories of treatment response and psychosocial function in CM. Future research may benefit from examining these factors in headache-specific treatment settings and in the context of examining the effects of multidisciplinary care on patients with complex symptom presentations.
METHODS: The current study utilized retrospective clinical registry data from 704 treatment-seeking patients with CM to examine longitudinal trajectories of pain intensity and pain-related life interference using linear growth modeling.
RESULTS: High levels of co-occurring non-cephalic pain (71.9% of patients) were noted in this sample. Patients endorsing more widespread pain reported higher average levels of pain intensity over time (β = 0.189 [0.103-0.275], P < .001) and less improvement in pain interference over time (β = 0.328 [0.131-0.525], P = .001). Additional findings included greater reductions in pain interference among patients with higher baseline levels of pain intensity (β = -0.185 [-0.351 to -0.020], P = .028) and fatigue (β = -0.280 [-0.493 to -0.067], P = .010) and non-significant associations between post-traumatic stress symptoms and pain intensity and pain interference in all models.
CONCLUSIONS: The current findings suggest that clinical factors sometimes overlooked in headache research, such as co-occurring non-cephalic pain and fatigue, may contribute to trajectories of treatment response and psychosocial function in CM. Future research may benefit from examining these factors in headache-specific treatment settings and in the context of examining the effects of multidisciplinary care on patients with complex symptom presentations.