Field testing alternative criteria for chronic migraine

M. E. Bigal, S. J. Tepper, F. D. Sheftell, A. M. Rapoport, Richard B. Lipton

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

The criteria for chronic migraine (CM), as proposed by the Second Edition of the International Classification of Headache Disorders (ICHD-2) is very restrictive, excluding most patients that evolve from episodic migraine. In this study we empirically tested three recent proposals for revised criteria for CM. We included individuals with transformed migraine (TM) with or without medication overuse, according to the criteria proposed by Silberstein and Lipton. All individuals had headache calendars for at least three consecutive months. We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+). We also tested three proposals for making the CM criteria more inclusive. In proposal 1, CM/CM + would require at least 15 days of migraine or probable migraine per month. Proposal 2 suggests that CM/CM + would be classified in those with ≥ 15 days of headache per month, where at least 50% of these days are migraine or probable migraine. Proposal 3 suggests that CM/CM + would be classified in those with chronic daily headache and at least 8 days of migraine or probable migraine per month. Among TM sufferers, 399 (62.5%) had TM with medication overuse, and just 10.2% were classified as CM+ 158 (37.5%) had TM without medication overuse; just nine (5.6%) met current ICHD-2 criteria for CM. Using the alternative criteria, proposal 1 included 48.7% of patients with TM without medication overuse; proposal 2 captured 88%, and proposal 3 classified 94.9% of these patients. For TM with medication overuse, the proportions for proposals 1-3 were, respectively, 37%, 81% and 91%. The differences were statistically significant, favouring proposal 3. Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalCephalalgia
Volume26
Issue number4
DOIs
StatePublished - Apr 2006

Fingerprint

Migraine Disorders
Headache
Headache Disorders

Keywords

  • Chronic daily headache
  • Chronic migraine
  • Classification
  • Proposed criteria
  • Transformed migraine

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Bigal, M. E., Tepper, S. J., Sheftell, F. D., Rapoport, A. M., & Lipton, R. B. (2006). Field testing alternative criteria for chronic migraine. Cephalalgia, 26(4), 477-482. https://doi.org/10.1111/j.1468-2982.2006.01128.x

Field testing alternative criteria for chronic migraine. / Bigal, M. E.; Tepper, S. J.; Sheftell, F. D.; Rapoport, A. M.; Lipton, Richard B.

In: Cephalalgia, Vol. 26, No. 4, 04.2006, p. 477-482.

Research output: Contribution to journalArticle

Bigal, ME, Tepper, SJ, Sheftell, FD, Rapoport, AM & Lipton, RB 2006, 'Field testing alternative criteria for chronic migraine', Cephalalgia, vol. 26, no. 4, pp. 477-482. https://doi.org/10.1111/j.1468-2982.2006.01128.x
Bigal, M. E. ; Tepper, S. J. ; Sheftell, F. D. ; Rapoport, A. M. ; Lipton, Richard B. / Field testing alternative criteria for chronic migraine. In: Cephalalgia. 2006 ; Vol. 26, No. 4. pp. 477-482.
@article{94876b2a9a614fccb7085a1f70256f24,
title = "Field testing alternative criteria for chronic migraine",
abstract = "The criteria for chronic migraine (CM), as proposed by the Second Edition of the International Classification of Headache Disorders (ICHD-2) is very restrictive, excluding most patients that evolve from episodic migraine. In this study we empirically tested three recent proposals for revised criteria for CM. We included individuals with transformed migraine (TM) with or without medication overuse, according to the criteria proposed by Silberstein and Lipton. All individuals had headache calendars for at least three consecutive months. We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+). We also tested three proposals for making the CM criteria more inclusive. In proposal 1, CM/CM + would require at least 15 days of migraine or probable migraine per month. Proposal 2 suggests that CM/CM + would be classified in those with ≥ 15 days of headache per month, where at least 50{\%} of these days are migraine or probable migraine. Proposal 3 suggests that CM/CM + would be classified in those with chronic daily headache and at least 8 days of migraine or probable migraine per month. Among TM sufferers, 399 (62.5{\%}) had TM with medication overuse, and just 10.2{\%} were classified as CM+ 158 (37.5{\%}) had TM without medication overuse; just nine (5.6{\%}) met current ICHD-2 criteria for CM. Using the alternative criteria, proposal 1 included 48.7{\%} of patients with TM without medication overuse; proposal 2 captured 88{\%}, and proposal 3 classified 94.9{\%} of these patients. For TM with medication overuse, the proportions for proposals 1-3 were, respectively, 37{\%}, 81{\%} and 91{\%}. The differences were statistically significant, favouring proposal 3. Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.",
keywords = "Chronic daily headache, Chronic migraine, Classification, Proposed criteria, Transformed migraine",
author = "Bigal, {M. E.} and Tepper, {S. J.} and Sheftell, {F. D.} and Rapoport, {A. M.} and Lipton, {Richard B.}",
year = "2006",
month = "4",
doi = "10.1111/j.1468-2982.2006.01128.x",
language = "English (US)",
volume = "26",
pages = "477--482",
journal = "Cephalalgia",
issn = "0333-1024",
publisher = "SAGE Publications Ltd",
number = "4",

}

TY - JOUR

T1 - Field testing alternative criteria for chronic migraine

AU - Bigal, M. E.

AU - Tepper, S. J.

AU - Sheftell, F. D.

AU - Rapoport, A. M.

AU - Lipton, Richard B.

PY - 2006/4

Y1 - 2006/4

N2 - The criteria for chronic migraine (CM), as proposed by the Second Edition of the International Classification of Headache Disorders (ICHD-2) is very restrictive, excluding most patients that evolve from episodic migraine. In this study we empirically tested three recent proposals for revised criteria for CM. We included individuals with transformed migraine (TM) with or without medication overuse, according to the criteria proposed by Silberstein and Lipton. All individuals had headache calendars for at least three consecutive months. We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+). We also tested three proposals for making the CM criteria more inclusive. In proposal 1, CM/CM + would require at least 15 days of migraine or probable migraine per month. Proposal 2 suggests that CM/CM + would be classified in those with ≥ 15 days of headache per month, where at least 50% of these days are migraine or probable migraine. Proposal 3 suggests that CM/CM + would be classified in those with chronic daily headache and at least 8 days of migraine or probable migraine per month. Among TM sufferers, 399 (62.5%) had TM with medication overuse, and just 10.2% were classified as CM+ 158 (37.5%) had TM without medication overuse; just nine (5.6%) met current ICHD-2 criteria for CM. Using the alternative criteria, proposal 1 included 48.7% of patients with TM without medication overuse; proposal 2 captured 88%, and proposal 3 classified 94.9% of these patients. For TM with medication overuse, the proportions for proposals 1-3 were, respectively, 37%, 81% and 91%. The differences were statistically significant, favouring proposal 3. Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.

AB - The criteria for chronic migraine (CM), as proposed by the Second Edition of the International Classification of Headache Disorders (ICHD-2) is very restrictive, excluding most patients that evolve from episodic migraine. In this study we empirically tested three recent proposals for revised criteria for CM. We included individuals with transformed migraine (TM) with or without medication overuse, according to the criteria proposed by Silberstein and Lipton. All individuals had headache calendars for at least three consecutive months. We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+). We also tested three proposals for making the CM criteria more inclusive. In proposal 1, CM/CM + would require at least 15 days of migraine or probable migraine per month. Proposal 2 suggests that CM/CM + would be classified in those with ≥ 15 days of headache per month, where at least 50% of these days are migraine or probable migraine. Proposal 3 suggests that CM/CM + would be classified in those with chronic daily headache and at least 8 days of migraine or probable migraine per month. Among TM sufferers, 399 (62.5%) had TM with medication overuse, and just 10.2% were classified as CM+ 158 (37.5%) had TM without medication overuse; just nine (5.6%) met current ICHD-2 criteria for CM. Using the alternative criteria, proposal 1 included 48.7% of patients with TM without medication overuse; proposal 2 captured 88%, and proposal 3 classified 94.9% of these patients. For TM with medication overuse, the proportions for proposals 1-3 were, respectively, 37%, 81% and 91%. The differences were statistically significant, favouring proposal 3. Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.

KW - Chronic daily headache

KW - Chronic migraine

KW - Classification

KW - Proposed criteria

KW - Transformed migraine

UR - http://www.scopus.com/inward/record.url?scp=33645113515&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645113515&partnerID=8YFLogxK

U2 - 10.1111/j.1468-2982.2006.01128.x

DO - 10.1111/j.1468-2982.2006.01128.x

M3 - Article

C2 - 16556250

AN - SCOPUS:33645113515

VL - 26

SP - 477

EP - 482

JO - Cephalalgia

JF - Cephalalgia

SN - 0333-1024

IS - 4

ER -