Neurologic and psychiatric comorbidity in migraine patients

Abstract

Objective: The aim of this study was to determine the frequency of subclinical infarctions and white matter lesions (WML), to analyze the relation between migraine and the level of depression, anxiety and obsessive-compulsive symptoms, and to examine the effect of the frequency and type of migraine on these disorders in patients with migraine-type headache. Material and Methods: Patients who were followed-up in the Headache Outpatient Clinic in the Department of Neurology at the Süleyman Demirel University with a diagnosis of migraine according to the International Headache Society criteria were included in the study. The study group included, 123 patients (aged between 19 and 60) with migraine-32 with aura, 91 without aura-and 114 healthy controls. Hamilton Depression and Anxiety Rating Scale and Maudsley Obsessive-Compulsive Inventory (MOCI) were used for psychological assessment. Results: White matter lesions were determined in 16.9% of migraine cases; the rate of deep white matter lesions (DWML) were significantly higher in migraine patients than in the control group (p=0.003); this difference was significant. Although the prevalence of periventricular white matter lesions (PWML) was higher in migraine patients compared to controls, the difference was not significant. DWML and PWML were higher in patients with aura than in those without; the difference being insignificant (p>0.05). Mean scores of all three psychiatric scales (Hamilton Depression and Anxiety Rating Scale and MOCI) were higher in migraine patients than in the control group with statistical significance in all but the MOCI score (p<0.05). Conclusion: Depression and anxiety levels were high in migraine patients. Therefore, psychiatric evaluation of patients with migraine is important. The presence of WML in patients with migraine should be considered a risk factor and indicator for cerebrovascular diseases. © 2013 by Türkiye Klinikleri.