| A cross-sectional survey study of primary headache and fibromyalgiaObjective: By investigating the past and present medical history of headache clinic patients,we understood the distribution of primary headache in headache clinic,and preliminarily estimated the combination rate of primary headache and fibromyalgia comorbidity;discussed the relationship between primary headache and fibromyalgia,anxiety-depression disorder,and sleep disorder,and preliminarily developed a prediction model for the occurrence of adverse outcomes in primary headache,which provides a basis for assessing the transformation of primary headache outcomes in headache clinic.Methods: A total of 162 patients with primary headache from three northeastern provinces and Inner Mongolia were included in this study,and general demographic data,headache duration,location,nature,frequency of headache attacks per month,number of headache days per month,duration of each headache,triggering or relieving factors,medication use,and other current medical history related to headache were collected,and visual analog scores（VAS scores）measuring headache severity were performed.The 2016 ACR Fibromyalgia Initial Diagnosis Questionnaire score,Hospital Anxiety and Depression Scale score,and Insomnia Severity Index scale score were collected and calculated.The outcome of headache transformation was determined based on the patients’ headache attacks,and the number of headache attack days ≥15 days/month was identified as a poor outcome of headache attacks.The rate of combination of primary headache and fibromyalgia was first determined based on the diagnosis of both.Then,the presence or absence of comorbidity with fibromyalgia,anxiety-depression disorder,and sleep disorder was explored to determine whether these types of factors had an impact on headache.Spearman correlation analysis was used to clarify the possible correlations between primary headache and fibromyalgia,anxiety-depression disorder,and sleep disorder.Finally,binary logistic regression analysis was used to identify the risk factors influencing the occurrence of adverse outcomes in headache.The ROC curve was used to obtain the best cut-off value of the risk factors as quantitative information,and then the risk factors were transformed into dichotomous information,and the correlation regression coefficients of the risk factors were determined by binary logistic regression analysis to obtain the regression equation,that is,the prediction rule of the prediction model,and then the cut-off value of the prediction model was obtained based on the ROC curve after simplifying the model.Results: In our study,we found that the combination of fibromyalgia was about 5.56% in patients with primary headache,and the combination of fibromyalgia could have an impact on the number of days of headache attacks（p < 0.05）.In addition,it was found that patients with primary headache complained of pain in other parts of the body,but the analysis did not reveal that pain in other parts of the body（not fibromyalgia）had an effect on the number of days of headache attacks,and the correlation analysis between the two was not positive（P > 0.05）.Primary headache combined with anxiety and depression disorders and sleep disorders negatively affected the number of headache attack days（P < 0.001）.For binary logistic regression analysis,the risk factors for the occurrence of adverse outcomes in headache were age,anxiety disorder,depression disorder,sleep disorder,and substance abuse,and the regression coefficients of the risk factors were determined by regression analysis and simplified to 1,2,1,1,and 3 in that order,and the critical value of the prediction model was determined to be 3 using the ROC curve.the overall correct prediction rate of this model was 82.7%.The prediction model was tested by the Hosmer-Lemeshow goodness-of-fit test 2=2.75,p=0.84.Conclusion: This study initially assessed the rate of primary headache combined with fibromyalgia in northeastern China,which was approximately 5.56%.The effects of risk factors such as age,anxiety disorders,depressive disorders,sleep disorders,and substance abuse on headache outcome transition were evaluated,and it was concluded that these indicators could be selected as predictors of headache outcome transition,making it easier and more reliable for physicians to predict headache outcome in patients at headache clinics.A meta-analysis of the effectiveness of vitamin D in the treatment of migraine and fibromyalgiaObjective: Effectiveness of vitamin D in the treatment of migraine and fibromyalgia was assessed by meta-analysis.Methods: The literature on vitamin D treatment for migraine or fibromyalgia published from the database of Wanfang,Chinese National Knowledge Infrastructure,VIP Full-Text Database of Chinese periodicals,Chinese Biomedical Literature Database,Pub Med,Web of science,Embase,Cochrane Library,etc.between the period of establishment and December 2021 was searched in Chinese or English only.Based on the established inclusion and exclusion criteria of the literature,the full text was read in detail,and valid data were extracted and meta-analysis was conducted using Revman 5.4 and Stata15.0 software.Results: A total of 5 RCT papers on vitamin D treatment for migraine and 5 RCT papers on vitamin D treatment for fibromyalgia were included in this study.Meta-analysis showed that after the application of vitamin D prophylaxis for migraine,there was a significant reduction in the number of migraine days per month in the vitamin D group compared to the control group compared to baseline（MD=-2.21,95% CI-3.31 to-1.10,P<0.001）;a reduction in the frequency of migraine attacks per month（MD=-2.39,95% CI-3.69 to-1.09,P<0.001）;and reduced migraine severity（VAS）（MD=-0.76,95% CI-1.22 to-0.30,P=0.001）.Compared with baseline,the Fibromyalgia Impact Questionnaire（FIQ）score decreased significantly in the vitamin D group compared with the control group（MD=-7.82,95% CI-12.05 to-3.59,P<0.001）;however,the difference in the decrease in fibromyalgia pain severity was not statistically significant（MD=-0.60,95% CI-1.38 to 0.17,P > 0.05）.Conclusion: Vitamin D is effective for migraines,but it may be effective for fibromyalgia. |
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