Evidence map›Paper›PMID 39627727›Full record

Observational studyThe journal of headache and pain2024

Resistant and refractory migraine - two different entities with different comorbidities? Results from the REFINE study.

C Rosignoli, R Ornello, V Caponnetto, A Onofri, S Avaltroni, M Braschinsky, O Šved, R Gil-Gouveia, C Lampl, J Paungarttner and 22 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

C RosignoliDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
R OrnelloDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
V CaponnettoDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
A OnofriDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
S AvaltroniDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
M BraschinskyDepartment of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia.
O ŠvedDepartment of Neurology and Neurosurgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia.
R Gil-GouveiaHeadache Center, Hospital da Luz, Lisbon, Portugal.
C LamplHeadache Medical Center, Seilerstaette Linz, Linz, Austria.
J PaungarttnerHeadache Medical Center, Seilerstaette Linz, Linz, Austria.
P MartellettiDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
W D Wells-GatnikDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.
I P MartinsCentro de Estudos Egas Moniz, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
D MitsikostasFirst Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
L ApostolakopoulouFirst Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
G NabaeiIranian Center of Neurological Research, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
A OzgeDepartment of Neurology, Mersin University Medical Faculty, Mersin, Turkey.
D B NarinDepartment of Neurology, Mersin University Medical Faculty, Mersin, Turkey.
P Pozo-RosichHeadache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
A Muñoz-VendrellHeadache Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
M P PrudenzanoHeadache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy.
M GentileHeadache Center, Amaducci Neurological Clinic, Policlinico General Hospital, Bari, Italy.
K RyliskieneCenter of Neurology, Vilnius University, Vilnius, Lithuania.
J VainauskieneCenter of Neurology, Vilnius University, Vilnius, Lithuania.
M Sanchez Del RioDepartment of Neurology, Clínica Universidad de Navarra, Madrid, Spain.
F VernieriUnit of Headache and Neurosonology, Fondazione Policlinico Campus Bio-Medico and Neurology, Università Campus Bio-Medico di Roma, Roma, Italy.
G IaccarinoUnit of Headache and Neurosonology, Fondazione Policlinico Campus Bio-Medico and Neurology, Università Campus Bio-Medico di Roma, Roma, Italy.
M Waliszewska-ProsolDepartment of Neurology, Wroclaw Medical University, Wrocław, Poland.
S BudrewiczDepartment of Neurology, Wroclaw Medical University, Wrocław, Poland.
M CarnovaliDepartment of Neurology, Christian Hospital Unna and University of Duisburg-Essen, Ruhr Metropolitan, Germany.
Z KatsaravaDepartment of Neurology, Christian Hospital Unna and University of Duisburg-Essen, Ruhr Metropolitan, Germany.
S SaccoDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it.

Funding

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy 07_DG_2024_10
6 · The paper itself

Abstract

backgroundResistant and refractory migraine are commonly encountered in specialized headache centers. Several comorbidities, mostly psychiatric conditions, have been linked to migraine worsening; however, there is little knowledge of the comorbidity profile of individuals with resistant and refractory migraine.

methodsREFINE is a prospective observational multicenter international study involving individuals with migraine from 15 headache centers. Participants were categorized into three groups based on the European Headache Federation criteria: non-resistant and non-refractory (NRNRM), resistant (ResM), and refractory (RefM). We explored the prevalence of 20 comorbidities at baseline in the three groups.

resultsOf the 689 included patients (82.8% women), 262 (38.0%) had ResM, 73 (10.4%) had RefM and 354 (51.4%) NRNRM. A higher prevalence of psychiatric comorbidities, trigger points, temporomandibular joint disorders, thyroiditis, and cerebrovascular diseases was observed in the RefM group, followed by ResM and NRNRM. Multiple comorbidities were more common in the RefM group, followed by the ResM group and by the NRNRM group (41.6% vs. 24.5% vs. 14.1% respectively; p < 0.001). At the sensitivity analysis, exploring participants with chronic migraine, significant differences among the NRNRM, ResM, and RefM groups were found in the prevalence of anxiety (p < 0.001), asthma and rhinitis (p = 0.013), bipolar and other psychiatric disorders (p = 0.049), cerebrovascular diseases (p < 0.001), depression (p < 0.001), obesity (p = 0.002), thyroiditis (p < 0.001), and trigger points (p = 0.008).

conclusionREFINE data indicate that individuals with ResM and RefM have a higher burden of comorbidities than those with NRNRM. It can be postulated that those comorbidities may have an impact on the progression of migraine from a form that is easy to treat to a form that is resistant or refractory to treatments. Longitudinal studies are needed to understand the direction of the association between ResM or RefM and those comorbidities and if proper treatment of comorbidities might help overcome treatment resistance or refractoriness.

Indexed as

ComorbidityMigraine DisordersAdultDrug ResistanceFemaleHumansMaleMental DisordersMiddle AgedPrevalenceProspective StudiesComorbiditiesMigraineRefractory migraineResistant migraine

Identifiers

PMID39627727
PMCPMC11613769

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.