Study On The Correlation Between 5-HT And Primary Headache Complicated With Sleep Disorders,Anxiety And Depression

Objective:To study the influencing factors of different severity of common complications of migraine and tension-type headache,sleep disorders,anxiety and depression,and to explore whether plasma 5-Hydroxytryptamine(5-HT)level can be used as an evaluation index for the severity of headache patients,so as to further guide clinical medication and research,provide clues and a basis for precise and individualized treatment.Methods:According to the inclusion and exclusion criteria,the headache patients who visited the Headache Clinic of the Second Hospital of Shanxi Medical University from July 2020 to July 2021,and those who entered the health check-up center without history of primary during the same period were included in the analysis.Through face-to-face questionnaires,the general clinical data(including gender,age,body mass index(BMI),education level,presence of late nights,presence of negative life events,personality characteristics,etc.)were collected;The severity of pain and their impact on daily life in headache patients were assessed by Visual Analogue Scale(VAS)and Headache Impact Test-6(HIT-6);The sleep status of the headache groups and the control group was evaluated by the Pittsburgh Sleep Quality Index(PSQI);the emotional state was evaluated by the 14-Item Hamilton Rating Scale for Anxiety(HAMA-14)and The 17-Item Hamilton Rating Scale for Depression(HAMD-17);the severity of sleep disturbance,anxiety and depression was evaluated in combination with the scoring criteria of each scale.5 ml blood from elbow vein was collected in the headache groups when in the intermittent period of headache and control group at 8:00 am in fasting state,then the upper plasma was separated and stored.The plasma 5-HT level was detected by enzyme linked immunosorbent assay(ELISA).By comparing the general clinical data,prevalence of sleep disorders,anxiety,depression and plasma 5-HT levels between the three groups(migraine group,tension-type headache(TTH)group and control group)and the three tension-type headache groups(infrequent episodic tension-type headache(IETTH),frequent episodic tension-type headache(FETTH),and chronic tension-type headache(CTTH)),to further analyze the influencing factors of headache,sleep disorders,anxiety,depression and plasma 5-HT levels,to comprehensively evaluate whether 5-HT could be used as a biochemical indicator of different severity of sleep disorder,anxiety and depression common in migraine and tension headache.Results:1 A total of 150 headache patients were enrolled in this study.There are 30 patients with migraine;120 with TTH,including 50 cases of IETTH,50 cases of FETTH and 20 cases of CTTH.The headache patients included 58 males and 92 females with an average age of 42.45±13.37 years.There were 120 cases in the control group,including 48 males and 72 females with an average age of 44.48±10.63 years.2 In the comparison of demographic and sociological factors,there were no statistically significant differences in gender,age,BMI,education level,staying up late and personality among the migraine group,TTH group and control group,and among the three TTH groups(IETTH,FETTH and CTTH group).However,in terms of negative life events,there were statistically significant differences among the migraine group,TTH group and control group,and among the three TTH groups.No negative life events were risk factors for the development of migraine and TTH,and patients with negative life events were more likely to develop CTTH.3 In the comparison of the severity of pain and its influence on daily life,there was no significant difference between the migraine group and TTH group in the VAS score.However,there was a statistically significant difference in HIT-6 scores,and the migraine group had a higher proportion of impact than the TTH group.The VAS score and HIT-6score were significantly different among the three TTH groups.With the increase of headache frequency,the pain became more severe,which had a greater impact on daily life.4 In PSQI score,HAMA-14 score and HAMD-17 score,there were statistically significant differences among the migraine group,TTH group and control group.The migraine group and TTH group were more prone to have sleep disorders,anxiety and depression,but there was no difference between the two headaches;in the comparison of the three groups of TTH,the difference was statistically significant.With the increase of headache frequency,the risks of sleep disorders,anxiety and depression also increased.The CTTH group had obvious pain,and was prone to severe sleep disturbance,obvious anxiety and severe depression.5 There were statistically significant differences in plasma 5-HT levels among the migraine group,TTH group and control group,among which the control group had differences compared with the migraine group and TTH group respectively,and the levels were higher than those in the headache groups.The differences among the three TTH groups were also statistically significant.Compared with IETTH group,plasma 5-HT level in CTTH group and FETTH group was significantly decreased.6 Multinomial logistic regression was used to analysis the influencing factors of headache.Plasma 5-HT level is a protective factor for IETTH,FETTH and migraine,PSQI level is a risk factor for FETTH and migraine,and depression level is a risk factor for IETTH and FETTH.Otherwise,FETTH is associated with an increased risk in men compared to women,but anxiety is a protective factor.7 By ordered logistic regression,the influencing factors of sleep disorders,anxiety and depression were analyzed separately.Anxiety and depression level,FETTH,CTTH and migraine were all risk factors for sleep disorders,and no protective factors were found.Depression and PSQI level were risk factors of anxiety,male and no negative life events were protective factors.Anxiety,PSQI level,IETTH,FETTH,CTTH and migraine were risk factors of depression,and no protective factors were found.8 Multiple linear regression analysis of the influencing factors of plasma 5-HT level showed that compared with the control group,the plasma 5-HT levels in the migraine group and three TTH groups were significantly lower.However,the significant influence of anxiety level,depression level and PISQ level on plasma 5-HT level could not be obtained.Conclusion:1 Migraine and tension-type headache were more likely to be combined with sleep disorders,anxiety and depression than the control group;among the three TTH groups,with the increase of headache frequency and severity,headache has a greater impact on daily life,and is more likely to be combined with sleep disorders,anxiety and depression.2 Compared with the control group,the plasma 5-HT levels in migraine and tension-type headache groups were lower,but there was no difference between migraine and tension-type headache groups;among the three TTH groups,the plasma 5-HT levels in the CTTH group were lower than those in the IETTH group and the FETTH group.3 Plasma 5-HT level is a protective factor for IETTH,FETTH and migraine,which can be used as a biochemical indicator of the presence and severity of headache,but cannot be used as a biochemical indicator to evaluate the severity of sleep disorder,anxiety and depression in headache patients.