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Abstract Details

Real-world Diagnosis of Chronic Migraine in Patients with Cervical Dystonia Analyzed by Botulinum Neurotoxin Treatment Exposure: An Epidemiologic Perspective
General Neurology
P9 - Poster Session 9 (11:45 AM-12:45 PM)
2-012
Describe the real-world diagnosis, demographics, and clinical characteristics of chronic migraine (CM) in cervical dystonia (CD) patients stratified by botulinum neurotoxin (BoNT) treatment.
Migraine is a common comorbidity in patients with CD; however, the diagnosis of CM in patients with CD is unknown.

This observational retrospective cohort study used longitudinal patient-level data from the Optum Market Clarity Database in the US. CD cohort includes patients ≥18y with ≥2 CD diagnoses ≥30d apart during the study (January 1, 2017 - September 30, 2021) and ≥180d of continuous health plan enrollment prior to cohort entry (first CD diagnosis coding). Cohort 1: CD+migraine/headache patients; cohort 2: CD+CM patients; cohorts 3 and 4: CD+CM BoNT- treated and CD+CM BoNT-untreated patients, respectively. Assessments include diagnosis, demographics and clinical characteristics of migraine/headache and CM in the CD cohort.
Of 81,884 CD patients, 36.1% had migraine/headache (cohort 1, n=29,533) and 12.6% had concurrent CM (cohort 2, n=10,284). There were more CD+CM patients in cohort 4 (BoNT-untreated) than cohort 3 (BoNT-treated) (57.4% vs 42.6%); cohort 3 had more older patients and fewer African Americans. Common comorbidities were comparable across cohorts 1-4 (neck pain, range: 63.6%-78.8%; psychiatric conditions, range: 37.5%-43.3%). The proportion of patients with psychiatric conditions in the CD+CM cohort (42.9%) was greater as compared to the overall CD cohort (28.1%). OnabotulinumtoxinA was the most used BoNT for CD or CM across cohorts 1-3. CD+CM patients treated with BoNT for both CD and CM diagnoses were higher (24.6%) than those treated for CD or CM individually (19.6% and 16.6%). 
CM is a common comorbidity in CD patients. Providers should be aware that patients may have both CD and CM, underscoring the importance of diagnosis and selection of appropriate treatment for managing these disease states. Further study is needed on the clinical phenotype of CD in CM patients.
Authors/Disclosures
Susan W. Broner, MD (Weill Cornell Medicine Department of Neurology)
PRESENTER 		Dr. Broner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Broner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer.
Ramon L. Rodriguez Cruz, MD, FAAN (Neurology One) The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Supernus . The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Boston Scientific. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbott. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Kyoway Kirin. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Rodriguez Cruz has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amneal. The institution of Dr. Rodriguez Cruz has received research support from Cerevance. The institution of Dr. Rodriguez Cruz has received research support from Neuraly. The institution of Dr. Rodriguez Cruz has received research support from Amneal. The institution of Dr. Rodriguez Cruz has received research support from Teva. The institution of Dr. Rodriguez Cruz has received research support from Neurocrine. Dr. Rodriguez Cruz has received publishing royalties from a publication relating to health care.
Grace I. Forde, MD Dr. Forde has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie.
Christopher P. Rhyne, MD (Diamond Headache Clinic) Dr. Rhyne has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Rhyne has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie/Allergan. Dr. Rhyne has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Abbvie/Allergan. Dr. Rhyne has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck.
Marjan Sadeghi, PharmD (Abbvie) Dr. Sadeghi has received personal compensation for serving as an employee of AbbVie. Dr. Sadeghi has stock in Abbvie.
Emma Yue (AbbVie) Dr. Yue has received personal compensation for serving as an employee of AbbVie.
Ahunna Ukah (Abbvie) Ahunna Ukah has received personal compensation for serving as an employee of AbbVie. Ahunna Ukah has stock in AbbVie.
Kimberly Ifantides Kimberly Ifantides has received personal compensation for serving as an employee of AbbVie. Kimberly Ifantides has stock in Abbvie.
Harini Sarva, MD, FAAN (Weill Cornell Medical Center) Dr. Sarva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Sarva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuroderm. Dr. Sarva has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Insightec. The institution of Dr. Sarva has received research support from Insightec. The institution of Dr. Sarva has received research support from NeuroNext. The institution of Dr. Sarva has received research support from Neuroderm. The institution of Dr. Sarva has received research support from Sun Pharma. The institution of Dr. Sarva has received research support from Prevail. The institution of Dr. Sarva has received research support from Bluerock Therapeutics. The institution of Dr. Sarva has received research support from Biogen. The institution of Dr. Sarva has received research support from Roche. The institution of Dr. Sarva has received research support from National Institute of Aging. The institution of Dr. Sarva has received research support from Michael J Fox Foundation. The institution of Dr. Sarva has received research support from Novo Nordisk. The institution of Dr. Sarva has received research support from Bukwang. The institution of Dr. Sarva has received research support from Bial. The institution of Dr. Sarva has received research support from Cerevance. The institution of Dr. Sarva has received research support from UCB. The institution of Dr. Sarva has received research support from MeiraGTX. The institution of Dr. Sarva has received research support from Biohaven. The institution of Dr. Sarva has received research support from Vima.