A recent study published in the Journal of Neurosciences in Rural Practice has found that patients with chronic migraine are more likely to experience fatigue and related comorbid disorders compared to those with episodic migraine. The findings suggest the importance of addressing these symptoms when creating a comprehensive treatment plan for migraine patients.
Migraine is a complex condition characterized by various triggers, associated illnesses, and manifestations. Episodic migraine can progress to chronic migraine, which is more challenging to manage and can significantly impact a patient’s quality of life. Chronic migraine accounts for a significant portion of headache cases seen in specialized clinics and affects approximately 1.4-2.2% of the general population.
The study observed that fatigue is a common accompaniment to migraine, with around 70% of migraine patients experiencing fatigue. Furthermore, chronic fatigue syndrome, a condition characterized by debilitating fatigue and other physical symptoms that are not relieved by rest, is 1.5 times more likely to occur in individuals with migraine. Headaches have also been reported in up to 59% of chronic fatigue syndrome patients.
To explore the occurrence and severity of fatigue and chronic fatigue syndrome in migraine patients, the researchers enrolled 60 adult patients with migraine (30 with episodic migraine and 30 with chronic migraine) from a tertiary referral center in New Delhi, India. The study aimed to analyze the relationship between fatigue and other comorbidities such as fibromyalgia, anxiety, and depression.
The results showed that patients with chronic migraine had a higher mean total duration of migraines and more frequent headaches compared to those with episodic migraine. They also had higher scores on measures of fatigue and a greater percentage of patients met the criteria for chronic fatigue syndrome. Fatigue was positively correlated with the frequency, duration, severity, and chronicity of migraine episodes, as well as excessive daytime sleepiness. Chronic fatigue syndrome was associated with fibromyalgia, depression, and anxiety.
The study acknowledges some limitations, including the use of a fatigue assessment tool that may not have captured fatigue experienced during different phases of migraines. There may have also been selection bias, as the study was conducted in a specialized clinic, and a control group was not included.
In conclusion, the findings of this study highlight the need to recognize and address fatigue and related comorbidities in migraine patients. The optimal treatment strategy for chronic migraine should go beyond treating the headache itself to include management of fatigue and its associated conditions, as well as psychosocial intervention and support.
– Kumar H, Dhamija K, Duggal A, Khwaja GA, Roshan S. Fatigue, chronic fatigue syndrome and migraine: Intersecting the lines through a cross-sectional study in patients with episodic and chronic migraine. J Neurosci Rural Pract. 2023;14(3):424-431.
– Natoli JL, Manack A, Dean B, Butler Q, Turkel CC, Stovner L, et al. Global prevalence of chronic migraine: A systematic review. Cephalalgia. 2010;30:599-609.