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Abstract Details

Multiple Sclerosis and Headache: A Further Examination of these Comorbid Conditions in Patients Receiving Care in a Multiple Sclerosis Center: A Cross-Sectional Study
Multiple Sclerosis
P4 - Poster Session 4 (5:30 PM-6:30 PM)
15-088
We sought to better understand the headache histories of Multiple Sclerosis (MS) Center patients with headaches.

MS and Migraine are comorbid neurologic conditions. Migraine is the world’s 2nd most disabling condition per the World Health Organization and its prevalence is three times higher in the MS clinic population compared to the general population. Research shows that patients with MS and migraine have more symptoms than MS patients without migraine. 

In an ongoing randomized controlled clinical trial of MS patients with 4+ headache days/month, headache histories (including treatments utilized) and varied symptomatology of MS-headache patients were collected during a baseline interview.

93 patients enrolled; 62 (67%) met ICHD 3 migraine criteria. Of those with MS-migraine, 55 (89%) were female. Mean age was 39+11. Headaches developed on average at 20+11 years. MS symptoms developed at 27+10 years and MS was diagnosed at 31+10 years. Mean number of headache days/month was 13+8. Average headache intensity on 0-10 pain scale was 7+2. Migraine Disability Assessment (MIDAS) scores averaged 39+39. Patients previously used the following for headache management: triptans 37% (23/62), opioids 35% (22/62), oral preventive medications 47% (29/62), botulinum toxin 15% (9/62). Top comorbid conditions were: chronic back pain (56%), anxiety (52%), depression (56%). Prevalent MS symptoms: fatigue (95%), weakness (94%), numbness (89%), emotional changes (74%), depression (71%), cognitive decline (73%), difficulty walking (73%), speech (65%), bladder (63%), bowel (45%).

In patients in a MS Center with frequent headaches (4+days/month), two thirds had migraine.  Headache onset averaged 7 years prior to MS symptom onset.  Migraine was highly disabling and MS symptoms were prominent. Over a third of patients have been on opioids. Top comorbid conditions were chronic back-pain, depression and anxiety.
Authors/Disclosures
Kathryn B. Schaubhut (NYUMC)
PRESENTER
No disclosure on file
No disclosure on file
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine) An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.
Leigh E. Charvet, PhD (NYU Langone) Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine) Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Mia T. Minen, MD, FAAN (NYULMC Neurology) The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI .