Abstract Details

Title Validation of diagnostic criteria for menstrual migraine

Topic Headache

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 204

Objective To assess validity of diagnostic criteria for menstrual migraine (MM).

Background Criteria for MM have not been sufficiently validated and are part of the ICHD-3 Appendix.

Design/Methods We performed a longitudinal E-diary study in premenopausal women with migraine. MM diagnosis was self-reported at baseline and was verified according to diary based (DB) ICHD-3 criteria and using a statistical model for menstrual migraine (sMM). Validity of self-reported MM compared to DB ICHD-3 and sMM was assessed. In addition, test-retest reliability and concordance between DB ICHD-3 and sMM were determined. Lastly, clinical characteristics of perimenstrual versus non-perimenstrual migraine attacks were compared for women with and without MM.

Results A total of 607 women were included. Specificity of self-reported MM was very poor (18-21%). Both women who did report and women who did not report an association between their migraine and menstrual cycle fulfilled diagnostic criteria (DB ICHD-3) in approximately two third of cases. Concordance between DB ICHD-3 and sMM was fair (κ=0.28, 95%CI: 0.23-0.33). Both methods had a test-retest reliability of approximately 70%. Women diagnosed with either method showed a 37-50% longer attack duration and increased triptan intake (OR 1.19-1.22, p<0.001) during perimenstrual attacks, while no such differences were found in women without MM.

Conclusions Approximately two third of women, both women who do recognize an association between their migraine and menstrual cycle and women who do not, fulfill E-diary-based ICHD-3 criteria for menstrual migraine (MM). Thus, MM diagnosis should not be based on self-reports. E-diary-based attack registration enables distinction between women who suffer from (more severe) perimenstrual migraine attacks and women who do not.

Authors/Disclosures
Iris Verhagen, MD PRESENTER	The institution of Ms. Verhagen has received research support from Hersenstichting. The institution of Ms. Verhagen has received research support from ZonMw.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Antoinentte Maassen Van Den Brink, PhD (Erasmus Medical Center Rotterdam)	Antoinentte Maassen Van Den Brink, PhD has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Antoinentte Maassen Van Den Brink, PhD has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Antoinentte Maassen Van Den Brink, PhD has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. The institution of Antoinentte Maassen Van Den Brink, PhD has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. The institution of Antoinentte Maassen Van Den Brink, PhD has received research support from Novartis.
G.M. Terwindt (MSD BV B03)	G.M. Terwindt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis, Teva, Allergan, Lilly, Lundbeck. The institution of G.M. Terwindt has received research support from Dutch Research Council, Dutch Brain Council, IRRF, Dioraphte.

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