Prevalence of Headache High in Patients With MS

There is a high prevalence of headache among patients with multiple sclerosis, particularly migraine, according to a recent review of published studies.

The authors of the study, published in Brain and Behavior, noted that reported prevalence of primary headaches among patients with MS has ranged from 35.5% to 70%, with migraine and tension‐type headache being the most frequent. This study aimed to get a better understanding of the epidemiology of these headaches through a systematic review and meta‐analysis.

They included observational studies which were cohort, case–control, or cross‐sectional studies, where patients had a diagnosis of primary headache such as migraine (with or without aura), tension‐type headache, or cluster headache.

The researchers searched electronic databases such as PubMed, Embase, and Scopus and identified 62 articles, with 16 included in the final analysis.

The 16 eligible studies, including 3560 patients with MS, were made up of 7 case–control studies and 9 cross‐sectional studies. The majority (13) were considered high quality, and 3 were considered moderate quality.

The pooled estimated prevalence of primary headaches was 56%. The pooled estimated prevalence of migraine (55%) was higher compared with tension‐type headache (20%).

The prevalence of migraine subtype was 16% and 10% for migraine without aura and migraine with aura, respectively. The pooled prevalence of primary headache in the case–control group (57%) was approximately in line with the cross‐sectional group (56%).

Overall, the statistical heterogeneity was moderate with I² of 82.1% (P < .001).

The authors wrote that while the underlying mechanism between headaches and MS is not clear, it is possible that the location of plaques in MS was closely associated with an increased occurrence of migraine.

“Clinical screening of headache among patients with MS will be helpful to formulate an individualized treatment plans and alleviate the physical and mental impact of the disease,” they concluded.

Reference

Wang L, Zhang J, Deng Z-R, Zu M-D, Wang Y. The epidemiology of primary headaches in patients with multiple sclerosis. Brain Behav. Published online December 8, 2020. doi: 10.1002/brb3.1830