Risk Factors Of Migraine With Anxiety Or Depression

Background:Migraine is a highly prevalent and disabling neurological disorder.The prevalence of right-to-left shunt（RLS）is higher in migraine patients.The prevalence of anxiety and depression in migraine people is also much higher than that in the general population.Mental complications increase the suffering of migraineurs.At present,there are few studies on the correlation between RLS and anxiety or depression.This study analyzed the social demography and headache-related data of migraine patients in order to find out the high risk factors of anxiety or depression in migraine patients.Methods:This study is an observational study.Migraine patients who were treated in the first Hospital of Jilin University from January 1,2019 to January 1,2020 were enrolled,and healthy controls matched with age and sex were recruited.Patients with migraine were examined by contrast-enhanced transcranial Doppler（c-TCD）to determine the presence of RLS.RLS was divided into permanent shunt and provoked shunt according to whether there is presence of the micro-bubbles（MBs）signals in resting state and divided into 0,1,2,3 and 4 grades according to the number of MBs.We also collected the basic demographic information and headache characteristics of migraine patients.The depression and anxiety status of all subjects were evaluated by Hamilton Depression scale（HAM-D）and Hamilton anxiety scale（HAM-A）,and migraine patients were divided into groups according to different depression or anxiety levels.Visual analogue score（VAS）was used to evaluate the degree of pain.Headache impact test-6（HIT-6）and migraine disability assessment scale（MIDAS）were used to evaluate the effects of migraine and the severity of disability caused by headache.The risk factors of migraine with anxiety or depression were analyzed by logistic multivariate regression.Results:A total of 100 migraine patients and 72 healthy controls were included in the statistical analysis.There was significant difference in the median scores of HAM-D and HAM-A between migraine group and healthy control group（7vs1,P<0.001;9vs1,P<0.001）.Compared with patients without depression,migraine patients with depression had a higher median age（40vs32years,P=0.001）,a higher proportion of women（84.9%vs54.7%,P=0.002）,shorter years of education（12vs16years,P=0.014）,and significant differences in educational background（P=0.005）.There was no significant difference in body mass index and annual income between the two groups.The duration of headache in migraine patients with depression was longer than that in patients without depression（12vs10years,P=0.048）,and the scores of HIT-6（64vs59,P=0.021）and MIDAS（25vs18,P=0.012）)were higher.There was no significant difference in age of onset,frequency of attack,presence or absence of aura,history of acute medication,history of preventive medication,family history,VAS score,RLS grade and subtypes between the two groups.Compared with patients without anxiety,the median age of migraine patients with anxiety was older（40vs31years,P<0.001）,and the proportion of women was higher（80.6%vs54.5%,P=0.006）.There was no significant difference in body mass index,educational background,years of education and annual income between the two groups.Compared with patients without anxiety,migraineurs with anxiety had longer headache duration（12vs9 years,P=0.018）and higher frequency of headache attacks（5vs3.5days/month,P=0.033）.The scores of HIT-6（63vs59,P=0.021）and MIDAS（25vs,P=0.001）scale of migraine patients with anxiety were higher than those of patients without anxiety.There was no significant difference in age of onset,aura,history of acute medication,history of preventive medication,family history,VAS score,RLS grade and subtypes between the two groups.Through logistic multivariate regression analysis,it was found that age was an independent risk factor for migraine with anxiety.Conclusion:Multiple variables are associated with migraine with anxiety or depression.Age is an independent risk factor for migraine with anxiety.