Abstract Details

Title Change in Catastrophizing After Onabotulinumtoxin A Treatment in Chronic Migraine with Medication Overuse: Preliminary Findings

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-021

Objective The primary aim was to evaluate change in catastrophizing in response to a standard course of medication treatment.

Background Catastrophizing has been shown to impact brain functioning, disease chronicity, and symptom severity in chronic migraine, but whether medication treatment serves to reduce the level of catastrophizing is unknown.

Design/Methods Sixty-eight patients (8 males, 60 females), with Chronic Migraine & Medication Overuse (ICHD-3 criteria), are enrolled in an open-label trial to preliminarily assess changes in catastrophizing, using the Pain Catastrophizing Scale (PSC), upon treatment with Onabotulinumtoxin A according to the PREEMPT protocol, at the dosage of 195 UI, after a 5-day structured day hospital withdrawal. The PSC was completed prior to and 6 months after treatment. Improvements in disability (MIDAS Questionnaire), quality of life (HIT-6), and headache days and medication consumption per month (assessed by daily diaries) were also collected at these same time points (the latter to document medication effectiveness).

Results Forty-three patients, all females (mean age 46.4 ± 8.7 years, migraine onset 18.2 ± 10.5 years) have completed the trial to date. A sizeable, although non significant, reduction was observed for catastrophizing: 21% reduction from pretreatment to 6 months (PCS: 28.2±11 vs 22.4±10.8). Disability was reduced by 33%, but not statistically significant, with minimal changes noted for QOL (6%). Significant reductions were found, as expected, with respect to both headache measures: 38% for days of headache/month (22.7±7 vs 14±8.1) and 36% for medications/month (23±11.5 vs 14.7±14).

Conclusions

Sizeable improvements were observed at 6 months for catastrophizing, even though not significant. These preliminary findings regarding lessened catastrophizing are encouraging, with us continuing to achieve the target sample size and extending followup to 6 additional months to assess for enhanced effects over a more extended time period (as major effects upon psychological variables are often delayed).

Authors/Disclosures
Frank Andrasik PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Domenico D'Amico	No disclosure on file
Licia Grazzi, MD (Neurological Institute C Besta)	Dr. Grazzi has received personal compensation in the range of $0-$499 for serving as a Consultant for EliLilly. Dr. Grazzi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for allergan-abbvie.

��ɫ��

��ɫ��