Evidence map›Paper›PMID 40418385›Full record

ReviewCurrent pain and headache reports2025

Prognostic Value of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Profiles in Predicting Outcomes of Occipital Nerve Stimulation for Refractory Chronic Migraine: A Retrospective Bias-Corrected Multivariable Analysis.

Marco Mercieri, Matteo Luigi Giuseppe Leoni, Alessia Naccarato, Omar Viswanath, Samah Said Al Sarmi, Giustino Varrassi, Marco Cascella, Roberto Arcioni

Abstract readReview
In one paragraph

Review in Current pain and headache reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Marco MercieriDepartment of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy.
Matteo Luigi Giuseppe LeoniDepartment of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy. matteolg.leoni@gmail.com.
Alessia NaccaratoUnit of Anesthesia, Intensive Care and Pain Management, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy.
Omar ViswanathDepartment of Anesthesiology, Creighton University School of Medicine, Phoenix, AZ, USA.
Samah Said Al SarmiSultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City Muscat, Muscat, Sultanate of Oman.
Giustino VarrassiFondazione Paolo Procacci, Rome, 00193, Italy.
Marco CascellaDepartment of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081, Italy.
Roberto ArcioniSultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), University Medical City Muscat, Muscat, Sultanate of Oman.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRefractory chronic migraine (rCM) is characterized by debilitating headaches that do not respond adequately to conventional medical treatments, leaving patients severely disabled. In these rare cases, central cervical spinal cord stimulation or occipital nerve stimulation (ONS) may offer a potential therapeutic option. However, these techniques are not without risks, lack clear scientific evidence, and impose a significant economic burden. Therefore, it is crucial to identify parameters that can assist physicians in selecting appropriate candidates for implantation. This study aimed to investigate the role of psychological profiles in predicting outcomes for ONS in rCM patients.

methodsWe conducted a retrospective analysis on rCM patients treated with ONS at a second-level neuromodulation university facility. These patients were refractory to conventional medical treatments, including onabotulinumtoxin-A injections (monoclonal antibodies targeting CGRP were not yet available). The NRS for migraine intensity, the number of monthly migraine attacks, and drug consumption were assessed at 6-month and 12-month follow-ups post-implant. Psychological profiles were evaluated prior to OCN using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). A multivariable logistic regression model was developed to predict ONS outcomes, incorporating MMPI-2 as a covariate. The model's accuracy and performance were assessed through non-parametric bootstrap, calibration, and discrimination analyses.

resultsTwenty-three rCM patients were analysed. ONS was able to significantly reduce the pain intensity, the number of headache attacks per month, and drug consumption compared to pre-treatment levels at both 6- and 12-month follow-ups. The final multivariable logistic model at 12 months showed that the MMPI-2 Depression score was independently and negatively associated with favourable outcomes following ONS (optimism-adjusted OR 0.52, 95% CI 0.21-0.77, p = 0.03). The ROC curve indicated high model sensitivity (AUC: 0.96, 95% CI: 0.88-0.98), and the calibration plot revealed a good fit, with some improvement needed in mid-range predicted probabilities.

conclusionONS significantly reduced pain intensity, headache frequency, and drug use at the 12-month follow-up compared to pre-treatment levels. The MMPI-2 Depression score was an independent predictor of ONS failure, highlighting the importance of comprehensive psychological assessments in patient selection for ONS.

Indexed as

Electric Stimulation TherapyMigraine DisordersMMPIAdultChronic DiseaseFemaleHumansMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsPrognosisRetrospective StudiesTreatment OutcomeMinnesota Multiphasic Personality Inventory-2MMPI-2Neurostimulation outcomesOccipital nerve stimulationPsychological predictorsRefractory chronic migraine

Identifiers

PMID40418385
PMCPMC12106134

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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.