Impact of SARS-CoV-2 Infection and Vaccination on Migraine Symptoms during the COVID-19 Pandemic

Authors

  • Lénia Silva Serviço de Neurologia / Centro Hospitalar Universitário de Santo António, Porto, Portugal
  • Adriana Lopes Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Ana Pontes Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Ana Gonçalves Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Arlinda Chiteculo Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Beatriz Soares Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Inês Teixeira Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Maria Gonçalves Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Maria Alves Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Maria Cardia Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Mariana Monteiro Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Raquel Eiras Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Sara Costa Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
  • Inês Laranjinha Serviço de Neurologia / Centro Hospitalar Universitário de Santo António, Porto, Portugal
  • Carlos Andrade Serviço de Neurologia / Centro Hospitalar Universitário de Santo António, Porto, Portugal
  • Denis Gabriel Serviço de Neurologia / Centro Hospitalar Universitário de Santo António, Porto, Portugal

DOI:

https://doi.org/10.46531/sinapse/AO/230065/2024

Keywords:

COVID-19, Vaccines COVID-19, Migraine Disorders

Abstract

Introduction: Studies have shown the worsening of migraine associated with the COVID-19 infection and the pandemic more broadly. COVID-19 vaccination has also been associated with symptomatic headache, with high frequency among migraineurs. We aimed to assess the impact of COVID-19 diagnosis and vaccine administration on migraine, during the SARS-CoV-2 pandemic.
Methods: An online questionnaire was sent to migraine patients followed in a neurology outpatient clinic between March and November 2022. The survey inquired about migraine symptoms and treatment changes, as well as sleep changes, anxiety, and depressive symptoms during the pandemic, after a COVID-19 diagnosis and/or vaccination.
Results: Out of the 185 patients included, 108 (58.4%) reported a change in headache pattern (intensity, frequency, and/or pain quality) and 47% reported higher intensity and frequency. The pattern changes occurred before the COVID-19 diagnosis in 41%. Of all the participants with headache changes 72.2% needed to intensify medication (abortive or prophylaxis), regardless of infection status. High levels of insomnia, anxiety, and depressive symptoms were found among patients with worsening migraine, irrespective of COVID-19 diagnosis. After vaccination, 49 (27.1%) described a change in headache pattern, with a worsening pattern in 29 (16%). In half, this change occurred for up to 3 weeks.
Conclusion: Worsening of migraine was more likely associated with other factors related to the pandemic rather than COVID-19 diagnosis. COVID-19 vaccination might have acted as an additional but less relevant and temporary trigger for migraine worsening.

Downloads

Download data is not yet available.

References

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38:1–211. doi: 10.1177/0333102417738202.

Lantéri-Minet M, Radat F, Chautard MH, Lucas C. Anxiety and depression associated with migraine: Influence on migraine subjects’ disability and quality of life, and acute migraine management. Pain. 2005;118319–26.

Sevillano-García MD, Manso-Calderón R, Cacabelos-Pérez P. Comorbilidad en la migraña: depresión, ansiedad, estrés y trastornos del sueño. Rev Neurol. 2007;45:400-5.

Ma M, Fang J, Li C, Bao J, Zhang Y, Chen N, et al. The status and high risk factors of severe psychological distress in migraine patients during nCOV-2019 outbreak in Southwest China: a cross-sectional study. J Headache Pain. 2020;21:100. doi: 10.1186/s10194-020-01168-5.

Holsteen KK, Hittle M, Barad M, Nelson LM. Development and internal validation of a multivariable prediction model for individual episodic migraine attacks based on daily trigger exposures. Headache. 2020;60:2364-79. doi: 10.1111/head.13960.

Moon HJ, Seo JG, Park SP. Perceived stress in patients with migraine: a case-control study. J Headache Pain. 2017;18:73. doi: 10.1186/s10194-017-0780-8.

Suzuki K, Takeshima T, Igarashi H, Imai N, Danno D, Yamamoto T, et al. Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study. J Headache Pain. 2021;22:53. doi: 10.1186/s10194-021-01263-1.

Gentile E, Delussi M, Abagnale C, Caponnetto V, de Cesaris F, Frattale I, et al. Migraine during COVID-19: Data from Second Wave Pandemic in an Italian Cohort. Brain Sci. 2021;11:482. doi: 10.3390/brainsci11040482.

Gonzalez-Martinez A, Planchuelo-Gómez Á, Guerrero ÁL, García-Azorín D, Santos-Lasaosa S, Navarro-Pérez MP, et al. Evaluation of the Impact of the COVID-19 Lockdown in the Clinical Course of Migraine. Pain Med. 2021;22:2079–91. doi: 10.1093/pm/pnaa449.

Verhagen IE, van Casteren DS, de Vries Lentsch S, Terwindt GM. Effect of lockdown during COVID-19 on migraine: A longitudinal cohort study. Cephalalgia. 2021;41:865–70. doi: 10.1177/0333102420981739.

Membrilla JA, Lorenzo Í, Sastre M, Díaz de Terán J. Headache as a Cardinal Symptom of Coronavirus Disease 2019: A Cross-Sectional Study. Headache. 2020;60:2176-91. doi: 10.1111/head.13967.

Parodi IC, Poeta MG, Assini A, Schirinzi E, del Sette P. Impact of quarantine due to COVID infection on migraine: a survey in Genova, Italy. Neurol Sci. 2020;41:2025-7. doi: 10.1007/s10072-020-04543-x.

Silvestro M, Tessitore A, Tedeschi G, Russo A. Migraine in the Time of COVID-19. Headache. 2020;60:988-9. doi: 10.1111/head.13803.

Schiano di Cola F, Caratozzolo S, di Cesare M, Liberini P, Rao R, Padovani A. Migraine Monitoring in the Time of COVID-19: Triggers and Protectors During a Pandemic. Pain Med. 2021;22:2728–38. doi: 10.1093/pm/pnab202.

Souza DD, Shivde S, Awatare P, Avati A, John SK, Badachi S, et al. Headaches associated with acute SARS-CoV-2 infection: A prospective cross-sectional study. SAGE Open Med. 2021;9:205031212110502. doi: 10.1177/20503121211050227.

Sampaio Rocha-Filho PA. Headache associated with COVID-19: Epidemiology, characteristics, pathophysiology, and management. Headache. 2022;62:650–6. doi: 10.1111/head.14319.

Salamanna F, Veronesi F, Martini L, Landini MP, Fini M. Post-COVID-19 syndrome: the persistent symptoms at the post-viral stage of the disease. a systematic review of the current data. Front Med. 2021;8:653516. doi: 10.3389/fmed.2021.653516.

Ferreira PL, Luzeiro I, Lopes M, Jorge A, Silva B, Ferreira L. Validity and reliability of the Portuguese version of the modified Migraine Disability Assessment. BMC Neurol. 2021;21:58. doi: 10.1186/s12883-021-02085-z.

Gomes AA, Marques DR, Meiavia AM, Cunha F, Clemente V. Psychometric properties and accuracy of the European Portuguese version of the Pittsburgh Sleep Quality Index in clinical and non-clinical samples. Sleep Biol Rhythms. 2018;16:413–22.

Pais-Ribeiro J, Silva I, Ferreira T, Martins A, Meneses R, Baltar M. Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol Health Med. 2007;12:225–37.

Ailani J, Burch RC, Robbins MS. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2022;62:111-2. doi: 10.1111/head.14245.

Bendtsen L, Sacco S, Ashina M, Mitsikostas D, Ahmed F, Pozo-Rosich P, et al. Guideline on the use of onabotulinum-toxinA in chronic migraine: a consensus statement from the European Headache Federation. J Headache Pain. 2018;19:91. doi: 10.1186/s10194-018-0921-8.

Sacco S, Braschinsky M, Ducros A, Lampl C, Little P, van den Brink AM, et al. European headache federation consensus on the definition of resistant and refractory migraine. J Headache Pain. 2020;21:76. doi: 10.1186/s10194-020-01130-5.

Bermejo PE, Dorado R. Zonisamide for Migraine Prophylaxis in Patients Refractory to Topiramate. Clin Neuropharmacol. 2009;32:103–6. doi: 10.1097/WNF.0B013E318170577F.

Al-Hashel JY, Ismail II. Impact of coronavirus disease 2019 (COVID-19) pandemic on patients with migraine: a webbased survey study. J Headache Pain. 2020;21:115. doi: 10.1186/s10194-020-01183-6.

Delussi M, Gentile E, Coppola G, Prudenzano AMP, Rainero I, Sances G, et al. Investigating the Effects of COVID-19 Quarantine in Migraine: An Observational Cross-Sectional Study From the Italian National Headache Registry (RICe). Front Neurol. 2020;11:597881. doi: 10.3389/fneur.2020.597881.

Fernández-de-las-Peñas C, Gómez-Mayordomo V, Cuadrado ML, Palacios-Ceña D, Florencio LL, Guerrero AL, et al. The presence of headache at onset in SARS-CoV-2 infection is associated with long-term post-COVID headache and fatigue: A case-control study. Cephalalgia. 2021;41:1332–41. doi: 10.1177/03331024211020404.

Garcia-Azorin D, Layos-Romero A, Porta-Etessam J, Membrilla JA, Caronna E, Gonzalez-Martinez A, et al. Post-COVID-19 persistent headache: A multicentric 9-months follow-up study of 905 patients. Cephalalgia. 2022;42:804–9. doi: 10.1177/03331024211068074.

Uygun Ö, Ertas M, Ekizoglu E, Bolay H, Özge A, Kocasoy Orhan E, et al. Headache characteristics in COVID-19 pandemic-a survey study. J Headache Pain. 2020;21:121. doi: 10.1186/s10194-020-01188-1.

Ji RR, Nackley A, Huh Y, Terrando N, Maixner W. Neuroinflammation and central sensitization in chronic and widespread pain. Anesthesiology. 2018;129:343–66. doi: 10.1097/ALN.0000000000002130.

Magdy R, Hussein M, Ragaie C, Abdel-Hamid HM, Khallaf A, Rizk HI, et al. Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study. Cephalalgia. 2020;40:1422–31. doi: 10.1177/0333102420965140.

Cho SJ, Chu MK. Risk factors of chronic daily headache or chronic migraine. Curr Pain Headache Rep. 2015;19:465. doi: 10.1007/s11916-014-0465-9.

Brennan KC, Charles A. Sleep and headache. Semin Neurol. 2009;29:406–18. doi: 10.1055/s-0029-1237113.

Alimoradi Z, Broström A, Tsang HWH, Griffiths MD, Haghayegh S, Ohayon MM, et al. Sleep problems during COVID-19 pandemic and its’ association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine. 2021 Jun;36:100916. doi: 10.1016/j.eclinm.2021.100916.

Kaur RJ, Dutta S, Bhardwaj P, Charan J, Dhingra S, Mitra P, et al. Adverse Events Reported From COVID-19 Vaccine Trials: A Systematic Review. Indian J Clin Biochem. 2021;36:427-39. doi: 10.1007/s12291-021-00968-z.

Sekiguchi K, Watanabe N, Miyazaki N, Ishizuchi K, Iba C, Tagashira Y, et al. Incidence of headache after COVID-19 vaccination in patients with history of headache: A cross-sectional study. Cephalalgia. 2022;42:266–72. doi: 10.1177/03331024211038654.

Ekizoglu E, Gezegen H, Yalınay Dikmen P, Orhan EK, Ertaş M, Baykan B. The characteristics of COVID-19 vaccine-related headache: Clues gathered from the healthcare personnel in the pandemic. Cephalalgia. 2022;42:366–75. doi: 10.1177/03331024211042390.

Castaldo M, Waliszewska-Prosół M, Koutsokera M, Robotti M, Straburzynski M, Apostolakopoulou L, et al. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. J Headache Pain. 2022;23:41. doi: 10.1186/s10194-022-01400-4.

Silvestro M, Tessitore A, Orologio I, Sozio P, Napolitano G, Siciliano M, et al. Headache Worsening after COVID-19 Vaccination: An Online Questionnaire-Based Study on 841 Patients with Migraine. J Clin Med. 2021;10:5914. doi: 10.3390/jcm10245914.

Göbel CH, Heinze A, Karstedt S, Morscheck M, Tashiro L, Cirkel A, et al. Clinical characteristics of headache after vaccination against COVID-19 (coronavirus SARS-CoV-2) with the BNT162b2 mRNA vaccine: a multicentre observational cohort study. Brain Commun. 2021;3:fcab169. doi: 10.1093/braincomms/fcab169. Erratum in: Brain Commun. 2021;3:fcab195.

Downloads

Published

2024-04-02

How to Cite

1.
Silva L, Lopes A, Pontes A, Gonçalves A, Chiteculo A, Soares B, et al. Impact of SARS-CoV-2 Infection and Vaccination on Migraine Symptoms during the COVID-19 Pandemic. Sinapse [Internet]. 2024 Apr. 2 [cited 2024 May 18];24(1):12-2. Available from: https://sinapse.pt/index.php/journal/article/view/42

Issue

Section

Original Articles