Impact of monthly headache days on migraine-related quality of life: Results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study

Allodynia; Anxiety; DepressionAl·lodínia; Ansietat; DepressióAlodinia; Ansiedad; DepresiónObjective To characterize the direct impact of monthly headache days (MHDs) on health-related quality of life (HRQoL) in people with migraine and the potential mediating effects of anxiety, depression, and allodynia. Background Although the general relationship between increased migraine frequency (i.e., MHDs) and reduced HRQoL is well established, the degree to which reduced HRQoL is due to a direct effect of increased MHDs or attributable to mediating factors remains uncertain. Methods Cross-sectional baseline data from participants with migraine who completed the Core and Comorbidities/Endophenotypes modules in the 2012–2013 US Chronic Migraine Epidemiology and Outcomes (CaMEO) study, a longitudinal web-based survey study, were analyzed. The potential contribution of depression, anxiety, and/or allodynia to the observed effects of MHDs on HRQoL as measured by the Migraine-Specific Quality-of-Life Questionnaire version 2.1 (MSQ) was evaluated. Results A total of 12,715 respondents were included in the analyses. The MSQ domain scores demonstrated progressive declines with increasing MHD categories (B = −1.23 to −0.60; p < 0.001). The observed HRQoL decrements associated with increasing MHDs were partially mediated by the presence of depression, anxiety, and allodynia. The MHD values predicted 24.0%–32.4% of the observed variation in the MSQ domains. Depression mediated 15.2%–24.3%, allodynia mediated 9.6%–16.1%, and anxiety mediated 2.3%–6.0% of the observed MHD effects on the MSQ. Conclusions Increased MHD values were associated with lower MSQ scores; the impact of MHDs on the MSQ domain scores was partially mediated by the presence of depression, anxiety, and allodynia. MHDs remain the predominant driver of the MSQ variation; moreover, most of the variation in the MSQ remains unexplained by the variables we analyzed. Future longitudinal analyses and studies may help clarify the contribution of MHDs, comorbidities, and other factors to changes in HRQoL

Impact of headache frequency and preventive medication failure on quality of life, functioning, and costs among individuals with migraine across several European countries: need for effective preventive treatment

Healthcare costs; Migraine; Treatment failureCostos d'atenció mèdica; Migranya; Fracàs del tractamentCostos de atención médica; Migraña; Fracaso del tratamientoBackground Data are limited regarding the combined impact of headache frequency and failure of preventive medication (efficacy and/or tolerability) on the humanistic/economic burden of migraine. Methods A retrospective, cross-sectional analysis of 2020 National Health and Wellness Survey (NHWS) data was conducted. An opt-in online survey identified adults in France, Germany, Italy, Spain, and United Kingdom with self-reported physician-diagnosed migraine. Participants with ≥ 4 monthly headache days (MHDs) were stratified by prior preventive medication use/failure (preventive naive; 0–1 failure; ≥ 2 failures). Quality-of-life and economic outcomes were compared among groups using generalized linear modeling. Results Among individuals with ≥ 4 MHDs (n = 1106), the NHWS identified 298 (27%) with ≥ 2 failures, 308 (28%) with 0–1 failure, and 500 (45%) as preventive naive. Individuals with ≥ 2 failures versus preventive-naive individuals had significantly lower scores on the 12-Item Short Form Survey Physical Component Summary (42.2 vs 44.1; P < 0.005), numerically higher scores on the Mental Component Summary (39.5 vs 38.5; P = 0.145), significantly higher scores on the Migraine Disability Assessment (39.1 vs 34.0; P < 0.05), and significantly higher prevalence of depression symptoms (62% vs 47%; P < 0.001) and anxiety symptoms (42% vs 31%; P < 0.01). The ≥ 2 failures group versus the preventive-naive group also had significantly more functional impairment as assessed by mean numbers of migraine-specific missed work days (7.8 vs 4.3) and household activities days (14.3 vs 10.6) in the past 6 months (P < 0.001) as well as the prevalence of absenteeism (19% vs 13%), overall work impairment (53% vs 42%), and activity impairment (53% vs 47%) (all P < 0.05). Emergency department visits (0.7 vs 0.5; P = 0.001) and hospitalizations (0.5 vs 0.3; P < 0.001) in the past 6 months were significantly higher in the ≥ 2 failures group versus the preventive-naive group, while indirect costs (€13,720 vs €11,282) and the proportion of individuals with non-adherence during the past 7 days (73% vs 64%) were numerically higher. Conclusions Increased burden, quality-of-life impairment, and functional impairment exist among individuals with migraine experiencing ≥ 4 MHDs and more treatment failures. While cause and directionality cannot be determined, these results suggest the need for effective preventive migraine treatments.Allergan (prior to its acquisition by AbbVie) funded this study and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship

Migraine-attributed burden, impact and disability, and migraine-impacted quality of life: Expert consensus on definitions from a Delphi process

Delphi; Migraine; DisabilityDelphi; Migraña; DiscapacidadDelphi; Migranya; DiscapacitatBackground Migraine-attributed burden, impact, disability and migraine-impacted quality of life are important concepts in clinical management, clinical and epidemiological research, and health policy, requiring clear and agreed definitions. We aimed to formulate concise and precise definitions of these concepts by expert consensus. Methods We searched the terms migraine-attributed burden, impact, disability and migraine-impacted quality of life in Embase and Medline from 1974 and 1946 respectively. We followed a Delphi process to reach consensus on definitions. Results We found widespread conflation of concepts and inconsistent terminology within publications. Following three Delphi rounds, we defined migraine-attributed burden as “the summation of all negative consequences of the disease or its diagnosis”; migraine-attributed impact as “the effect of the disease, or its diagnosis, on a specified aspect of life, health or wellbeing”; migraine-attributed disability as “physical, cognitive and mental incapacities imposed by the disease”; and migraine-impacted quality of life as “the subjective assessment by a person with the disease of their general wellbeing, position and prospects in life”. We complemented each definition with a detailed description. Conclusion These definitions and descriptions should foster consistency and encourage more appropriate use of currently available quantifying instruments and aid the future development of others.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by Eli Lilly and Company

Migraine-attributed burden, impact and disability, and migraine-impacted quality of life : Expert consensus on definitions from a Delphi process

Migraine-attributed burden, impact, disability and migraine-impacted quality of life are important concepts in clinical management, clinical and epidemiological research, and health policy, requiring clear and agreed definitions. We aimed to formulate concise and precise definitions of these concepts by expert consensus. We searched the terms migraine-attributed burden, impact, disability and migraine-impacted quality of life in Embase and Medline from 1974 and 1946 respectively. We followed a Delphi process to reach consensus on definitions. We found widespread conflation of concepts and inconsistent terminology within publications. Following three Delphi rounds, we defined migraine-attributed burden as "the summation of all negative consequences of the disease or its diagnosis"; migraine-attributed impact as "the effect of the disease, or its diagnosis, on a specified aspect of life, health or wellbeing"; migraine-attributed disability as "physical, cognitive and mental incapacities imposed by the disease"; and migraine-impacted quality of life as "the subjective assessment by a person with the disease of their general wellbeing, position and prospects in life". We complemented each definition with a detailed description. These definitions and descriptions should foster consistency and encourage more appropriate use of currently available quantifying instruments and aid the future development of other

Migraine-attributed burden, impact and disability, and migraine-impacted quality of life : Expert consensus on definitions from a Delphi process

Migraine-attributed burden, impact, disability and migraine-impacted quality of life are important concepts in clinical management, clinical and epidemiological research, and health policy, requiring clear and agreed definitions. We aimed to formulate concise and precise definitions of these concepts by expert consensus. We searched the terms migraine-attributed burden, impact, disability and migraine-impacted quality of life in Embase and Medline from 1974 and 1946 respectively. We followed a Delphi process to reach consensus on definitions. We found widespread conflation of concepts and inconsistent terminology within publications. Following three Delphi rounds, we defined migraine-attributed burden as "the summation of all negative consequences of the disease or its diagnosis"; migraine-attributed impact as "the effect of the disease, or its diagnosis, on a specified aspect of life, health or wellbeing"; migraine-attributed disability as "physical, cognitive and mental incapacities imposed by the disease"; and migraine-impacted quality of life as "the subjective assessment by a person with the disease of their general wellbeing, position and prospects in life". We complemented each definition with a detailed description. These definitions and descriptions should foster consistency and encourage more appropriate use of currently available quantifying instruments and aid the future development of other

The HADES RV Programme with HARPS-N@TNG IV. Time resolved analysis of the Ca ii H&K and H{\alpha} chromospheric emission of low-activity early-type M dwarfs

M dwarfs are prime targets for planet search programs, particularly of those focused on the detection and characterization of rocky planets in the habitable zone. Understanding their magnetic activity is important because it affects our ability to detect small planets, and it plays a key role in the characterization of the stellar environment. We analyze observations of the Ca II H&K and H{\alpha} lines as diagnostics of chromospheric activity for low-activity early-type M dwarfs. We analyze the time series of spectra of 71 early-type M dwarfs collected for the HADES project for planet search purposes. The HARPS-N spectra provide simultaneously the H&K doublet and the H{\alpha} line. We develop a reduction scheme able to correct the HARPS-N spectra for instrumental and atmospheric effects, and to provide flux-calibrated spectra in units of flux at the stellar surface. The H&K and H{\alpha} fluxes are compared with each other, and their variability is analyzed. We find that the H and K flux excesses are strongly correlated with each other, while the H{\alpha} flux excess is generally less correlated with the H&K doublet. We also find that H{\alpha} emission does not increase monotonically with the H&K line flux, showing some absorption before being filled in by chromospheric emission when H&K activity increases. Analyzing the time variability of the emission fluxes, we derive a tentative estimate of the rotation period (of the order of a few tens of days) for some of the program stars, and the typical lifetime of chromospheric active regions (a few stellar rotations). Our results are in good agreement with previous studies. In particular, we find evidence that the chromospheres of early-type M dwarfs could be characterized by different filaments coverage, affecting the formation mechanism of the H{\alpha} line. We also show that chromospheric structure is likely related to spectral type

The HADES RV Programme with HARPS-N@TNG II. Data treatment and simulations

The distribution of exoplanets around low-mass stars is still not well understood. Such stars, however, present an excellent opportunity of reaching down to the rocky and habitable planet domains. The number of current detections used for statistical purposes is still quite modest and different surveys, using both photometry and precise radial velocities, are searching for planets around M dwarfs. Our HARPS-N red dwarf exoplanet survey is aimed at the detection of new planets around a sample of 78 selected stars, together with the subsequent characterization of their activity properties. Here we investigate the survey performance and strategy. From 2700 observed spectra, we compare the radial velocity determinations of the HARPS-N DRS pipeline and the HARPS-TERRA code, we calculate the mean activity jitter level, we evaluate the planet detection expectations, and we address the general question of how to define the strategy of spectroscopic surveys in order to be most efficient in the detection of planets. We find that the HARPS-TERRA radial velocities show less scatter and we calculate a mean activity jitter of 2.3 m/s for our sample. For a general radial velocity survey with limited observing time, the number of observations per star is key for the detection efficiency. In the case of an early M-type target sample, we conclude that approximately 50 observations per star with exposure times of 900 s and precisions of about 1 m/s maximizes the number of planet detections

HADES RV Programme with HARPS-N at TNG. VII. Rotation and activity of M-Dwarfs from time-series high-resolution spectroscopy of chromospheric indicators

We aim to investigate the presence of signatures of magnetic cycles and rotation on a sample of 71 early M-dwarfs from the HADES RV programme using high-resolution time-series spectroscopy of the Ca II H & K and Halpha chromospheric activity indicators, the radial velocity series, the parameters of the cross correlation function and the V-band photometry. We used mainly HARPS-N spectra, acquired over four years, and add HARPS spectra from the public ESO database and ASAS photometry light-curves as support data, extending the baseline of the observations of some stars up to 12 years. We provide log(R'hk) measurements for all the stars in the sample, cycle length measurements for 13 stars, rotation periods for 33 stars and we are able to measure the semi-amplitude of the radial velocity signal induced by rotation in 16 stars. We complement our work with previous results and confirm and refine the previously reported relationships between the mean level of chromospheric emission, measured by the log(R'hk), with the rotation period, and with the measured semi-amplitude of the activity induced radial velocity signal for early M-dwarfs. We searched for a possible relation between the measured rotation periods and the lengths of the magnetic cycle, finding a weak correlation between both quantities. Using previous v sin i measurements we estimated the inclinations of the star's poles to the line of sight for all the stars in the sample, and estimate the range of masses of the planets GJ 3998 b and c (2.5 - 4.9 Mearth and 6.3 - 12.5 Mearth), GJ 625 b (2.82 Mearth), GJ 3942 b (7.1 - 10.0 Mearth) and GJ 15A b (3.1 - 3.3 Mearth), assuming their orbits are coplanar with the stellar rotation.Comment: 19 pages, 16 figures, 10 table

First results of the ALOS PALSAR verification processor

Among the several applications that will take advantage of the newly available data from the ALOS PALSAR instrument, considerable interest is in the peculiar features that derive from the penetration and polarimetric capabilities of the system. These capabilities, new for a single spaceborne sensor, need specific software tools for the processing of the different acquisition modes. This paper presents a verification processor, developed under ESA contract, for the generation of polarimetric, interferometric and polarimetric-interferometric geocoded products derived from ALOS PALSAR data. The processor, developed with a modular approach, contains the following main elements: - Phase-preserving fine resolution processor; - Phase-preserving ScanSAR processor; - Interference removal tools; - Polarimetric calibration tools; - Polarimetric analysis tools; - Fine resolution interferometric processor; - ScanSAR interferometric processor; - Polarimetric-interferometric processor; - Geocoding; - Atmospheric modelling tools. The processor architecture is presented; highlights are given on specific modules and algorithms. Early results are shown, in particular of the processing of polarimetric and polarimetric-interferometric data over different test sites