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Academia Mexicana de Neurología, A.C.

2018, Number 2

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Rev Mex Neuroci 2018; 19 (2)

Clinical, Psychoaffective and Neuropsychological Predictors in Response to Prophylactic Treatment of Chronic Daily Headache

Plascencia-Morán AA, Villaseñor CT, Amavisca Espinosa R, Jiménez-Maldonado ME, Rizo-Curiel G, Ruiz-Sandoval JL

Language: Spanish
References: 36
Page: 15-28
PDF size: 513.53 Kb.


ABSTRACT

Background: Daily chronic headache (CCD) represents a syndromic spectrum of diagnostic and therapeutic complexity affecting 3 to 5% of the general population.
Objective: To identify clinical, psychoaffective and neuropsychological predictors of good or poor response to the prophylactic pharmacological treatment of CCD.
Methods: Patients with CCD in previous prophylactic pharmacological treatment with age between 20 and 60 years were included. Several psycho-affective tests evaluated the level of anxiety, perception of illness, stress and depression; while neuropsychological domains evaluated attention, work memory, fluency and verbal memory. Good response to treatment was defined as a reduction of ≥ 50% in pain frequency.
Results: Forty patients with CCD (24 with chronic migraine and 16 with chronic tension-type headache) were included; 36 were women and 4 men with an average age of 40 years. Twenty patients were good responders (50%). A less frequency of headache (15 to 25 days per month) and the perception of treatment efficacy were associated with a good response (p = 0.053 and p = 0.008 respectively). There was significant tendency or association for better performance in work memory tests - inverse digits (p = 0.076), scalar digits score (p = 0.072), semantic verbal fluency (p = 0.001) - and the fifth item of the Perri test for verbal memory and learning (p = 0.021) among responders.
Conclusions: In this preliminary study, we identified a better overall and particular performance in some cognitive domains among patients with CCD and favorable response to established prophylactic treatment.


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