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Botulinum Toxin a Valuable Prophylactic Agent for Migraines and a Possible Future Option for the Prevention of Hormonal Variations-Triggered Migraines
Open AccessArticle

A Prospective Observational Cohort Study on Pharmacological Habitus, Headache-Related Disability and Psychological Profile in Patients with Chronic Migraine Undergoing OnabotulinumtoxinA Prophylactic Treatment

1
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
2
UOC Neurorehabilitation, AOUI Verona, 37134 Verona, Italy
3
Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
4
Unit of Neurology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar (Verona), Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally.
Toxins 2019, 11(9), 504; https://doi.org/10.3390/toxins11090504
Received: 2 August 2019 / Revised: 24 August 2019 / Accepted: 27 August 2019 / Published: 29 August 2019
(This article belongs to the Special Issue Botulinum Toxin for Neuropathic Pain Treatment)
Chronic Migraine (CM) is a disabling neurologic condition with a severe impact on functioning and quality of life. Successful therapeutic management of patients with CM is complex, and differences in therapeutic response could be attributable to genetically determined factors, sensitivity to pharmacological treatment, psychosocial and relational factors affecting the patient’s compliance and approach on the therapeutic treatment. The aim of this prospective observational study was to explore self-efficacy, coping strategies, psychological distress and headache-related disability in a cohort of 40 patients with CM (mean age: 46.73; standard deviation 13.75) treated with OnabotulinumtoxinA and the relationship between these clinical and psychological aspects and acute medication consumption during OnabotulinumtoxinA prophylactic treatment. Patients presented an overall significant reduction in the Headache Index (HI) (p < 0.001), HI with severe intensity (p = 0.009), and total analgesic consumption (p = 0.003) after the prophylactic treatment. These results are in line with the literature. Despite this, higher nonsteroidal anti-inflammatory drugs consumption was associated with higher psychological distress, higher HI with severe and moderate intensity, and worse quality of life. Conversely, triptans consumption was correlated with HI of mild intensity, and problem-focused coping strategies. To conclude, the psychological profile, and in particular, the psychological distress and specific coping strategies might influence the self-management of acute medication. View Full-Text
Keywords: psychological distress; pain; disability; Anti-Inflammatory Agents Non-Steroidal; drugs psychological distress; pain; disability; Anti-Inflammatory Agents Non-Steroidal; drugs
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MDPI and ACS Style

Gandolfi, M.; Donisi, V.; Marchioretto, F.; Battista, S.; Smania, N.; Del Piccolo, L. A Prospective Observational Cohort Study on Pharmacological Habitus, Headache-Related Disability and Psychological Profile in Patients with Chronic Migraine Undergoing OnabotulinumtoxinA Prophylactic Treatment. Toxins 2019, 11, 504.

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