Abstract Details

Title Characterization of the Epidemiologic Profile and Non-pharmacologic Therapy Utilization Profile of Functional Neurologic Disorder in Patients with Migraine from a Multicenter Electronic Medical Record Database

Topic Headache

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-008

Objective

To compare the epidemiologic and non-pharmacologic therapy utilization profile of migraine patients with and without functional neurologic disorders (FND). To understand the impact of non-pharmacologic therapies on healthcare utilization patterns in patients with migraine and FND.

Background

FND is an understudied neurologic condition affecting both motor and sensory functions without an attributable organic explanatory diagnosis. The relationship between FND and migraine remains limited.

Design/Methods

Using the TriNetX database, cohorts of migraine patients with FND with motor weakness (MwF, ICD10 G43 with F44.4) and migraine patients without FND with motor weakness (MwoF) were evaluated. Information was obtained regarding patient demographics, medical comorbidities, medications, treatment outcomes [emergency department usage (EDU) and inpatient hospitalizations (IH)], and non-pharmacologic therapy services [physical therapy (PT) and psychotherapy]. Propensity score-matched cohorts of MwF and MwoF with standardized characteristics (demographics, medications, and PT) were created to compare treatment outcomes.

Results

From a network population of 130,161,553 patients, we identified a total of 2,687,354 (prevalence 2.06%) with a diagnosis of migraine, of which 14,182 (0.53%, prevalence 0.01%) were MwF. For MwF compared to MwoF, the mean age was 40.1±16.5 vs 39.0±17.9, female-to-male ratio was 4.9 vs 3.3, 16.2% vs 11.4% were black. Treatment profiles of MwF vs MwoF include transient ischemic attack (11.6% vs 3.3%), cerebral infarction (9.4% vs 1.3%), PT (17.8% vs 9.2%), psychotherapy (10.5% vs 3.3%), EDU (24.6% vs 19.0%) and IH (22.7% vs 16.0%). All comparisons were statistically significant p<0.0001. Post-propensity score matching of MwF compared to MwoF revealed increased EDU (24.6% vs 20.9%, Risk Ratio (RR) 1.174, 95% CI [1.104, 1.248]) and IH (22.7% vs 17.2%, RR 1.313, [1.225, 1.409]).

Conclusions

MwF patients have a significantly higher proportion of black race, cerebrovascular diagnoses, non-pharmacologic therapy utilization, and use of hospital emergency and inpatient resources.

Authors/Disclosures
Victor Wang, MD (Thomas Jefferson University Hospital) PRESENTER	Dr. Wang has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. Dr. Wang has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie.
Ethan Le	No disclosure on file
Mario F. Peres, MD (Sao Paulo Headache Center)	Dr. Peres has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eurofarma. Dr. Peres has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Peres has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Libbs. Dr. Peres has received research support from CNPq. Dr. Peres has received research support from Allergan.
Hsiangkuo Yuan, MD, PhD (Jefferson Headache Center)	An immediate family member of Dr. Yuan has received personal compensation for serving as an employee of Merck. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pfizer. Dr. Yuan has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Salvia. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerenovous. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Regional Anesthesia and Pain Medicine. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Headache and Pain Reports. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology. Dr. Yuan has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cephalalgia. The institution of Dr. Yuan has received research support from NIH. The institution of Dr. Yuan has received research support from American Headache Society. The institution of Dr. Yuan has received research support from Pfizer. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received publishing royalties from a publication relating to health care. Dr. Yuan has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Yuan has received personal compensation in the range of $10,000-$49,999 for serving as a Invited speaker with Chinese Stroke Association.

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