Abstract Details

Title A History of Migraine Headache is Associated with Worse Disability and Walking Speed in a Cohort of Patients with MS

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-005

Objective To assess the association between a history of migraine and disability and neurological function in multiple sclerosis (MS) patients, and to determine whether migraine co-occurs with other comorbid conditions in MS patients.

Background Migraine headaches are common in people with MS. Whether migraine has a role in MS course or symptom severity is unknown.

Design/Methods

We conducted an observational study of MS patients who completed the MS Performance Test-based (MSPT) (iPad version of the MS Functional Composite) assessment of neurologic function and completed a questionnaire querying comorbidities, including a history of physician-diagnosed migraine. Other queried comorbidities included: diabetes, hypertension, hypercholesterolemia, heart disease, sleep apnea, depression, anxiety. We evaluated the association between a positive history of migraines and MS outcomes, including disability (Patient Determined Disease Steps [PDDS]) and objective neurological outcomes (walking speed, manual dexterity and processing speed) using generalized linear models adjusting for age, sex, MS subtype/duration, years of education, and body mass index. We also tested whether the pre-specified comorbidities were overrepresented in MS-migraineurs vs. MS-non-migraineurs.

Results We analyzed cross-sectional data from 289 participants (79% female, mean age: 49.2y [standard deviation: 12.9y], who completed MSPT and migraine questionnaires. Relative to MS-non-migraineurs, MS-migraineurs tended to be younger (mean age 44.3y[11.0y] vs. 50.4y[13.1y]; p=0.0008), overweight (73.9% vs. 51.6%; p=0.002), and have a history of depression (46.2% vs. 24.2%, p=0.0008) and anxiety (30.8% vs. 18.8%; p=0.04). MS-migraineurs also had increased odds of severe vs. mild disability (OR: 3.08; 95% CI: 1.04-9.20) and significantly slower walking speeds (9.08% slower; 95% CI: 0.82%-18.77%; p=0.03) relative to MS-non-migraineurs. A history of migraine was not associated with processing speed or manual dexterity.

Conclusions Traditional migraine risk factors such as obesity, anxiety and depression were also overrepresented in our cohort of MS-migraineurs. A history of migraine was associated with greater disability. Longitudinal studies should evaluate if migraine predicts future neurologic disability.

Authors/Disclosures
Anne D. Yacoub, MD PRESENTER	Dr. Yacoub has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie.
Kathryn Fitzgerald, PhD (Johns Hopkins University)	Dr. Fitzgerald has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Setpoint Medical. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
	No disclosure on file
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Octave. Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SetPoint. The institution of Dr. Mowry has received research support from Genentech/Roche. The institution of Dr. Mowry has received research support from Biogen. Dr. Mowry has received publishing royalties from a publication relating to health care.

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