Identifying Natural Subgroups of Migraine Based on Comorbidity and Concomitant Condition Profiles: Results of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study.

Objective: To identify natural subgroups of people with migraine based on profiles of comorbidities and concomitant conditions, hereafter referred to as comorbidities. Background: Migraine is a heterogeneous disease. Identifying natural subgroups (endophenotypes) may facilitate biological and geneti...

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Published in:Headache: The Journal of Head & Face Pain Vol. 58; no. 7; pp. 933 - 948
Main Authors: Lipton, Richard B., Fanning, Kristina M., Buse, Dawn C., Martin, Vincent T., Reed, Michael L., Manack Adams, Aubrey, Goadsby, Peter J.
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jul2018
Online Access:View this record in EBSCOhost
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      dt: Jul2018
      vid: 58
      iid: 7
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Identifying Natural Subgroups of Migraine Based on Comorbidity and Concomitant Condition Profiles: Results of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study.
      aug:
        au:
          Lipton, Richard B.
          Fanning, Kristina M.
          Buse, Dawn C.
          Martin, Vincent T.
          Reed, Michael L.
          Manack Adams, Aubrey
          Goadsby, Peter J.
        affil: Montefiore Headache Center, Bronx, NY, USA
      sug:
        subj:
          Migraine Epidemiology
          Comorbidity
          Chronic Disease
          Human
          Prospective Studies
          Surveys
          United States
          Migraine Diagnosis
          Data Analysis, Statistical
          Respiratory Tract Diseases
          Psychiatry
          Cardiovascular Diseases
          Headache
          Membership
          Severity of Disability
          Questionnaires
          Allodynia
          Health Services Misuse
          Epilepsy
      ab: Objective: To identify natural subgroups of people with migraine based on profiles of comorbidities and concomitant conditions, hereafter referred to as comorbidities. Background: Migraine is a heterogeneous disease. Identifying natural subgroups (endophenotypes) may facilitate biological and genetic characterization and the development of personalized treatment. Methods: The Chronic Migraine Epidemiology and Outcomes Study is a prospective web‐based survey study designed to characterize the course of migraine and related comorbidities in a systematic US sample of people with migraine. Respondents were asked if they ever had a specific comorbidity and, if present, whether the comorbidity was confirmed/diagnosed by a “doctor”; 62 comorbidities were available for analysis. Latent class analysis (LCA) modeling determined the optimal number of classes and a parsimonious set of comorbidities. Results: Of the 12,810 respondents with migraine, 11,837 reported ≥1 comorbidity and were included in this analysis. After statistical analysis and clinical judgment reduced the number of comorbidities, we selected an 8‐class model based on 22 comorbidities. Each class had a distinct pattern summarized as follows: Class 1, Most Comorbidities; Class 2, Respiratory/Psychiatric; Class 3, Respiratory/Pain; Class 4, Respiratory; Class 5, Psychiatric; Class 6, Cardiovascular; Class 7, Pain; Class 8, Fewest Comorbidities. The distribution of individuals across models was variable, with one‐third of respondents in Class 8 (Fewest Comorbidities) and <10% in Class 1 (Most Comorbidities). Demographic and headache characteristics, not used in assigning class membership, varied across classes. For example, comparing Class 1 (Most Comorbidities) and Class 8 (Fewest Comorbidities), Class 1 had a greater proportion of individuals with severe disability (Migraine Disability Assessment grade IV; 48.1% vs 22.3% of overall individuals) and higher rates of allodynia (67.6% vs 47.0%), medication overuse (36.4% vs 15.0%), chronic migraine (23.1% vs 9.1%), and aura (40.1% vs 28.8%). Conclusions: LCA modeling identified 8 natural subgroups of persons with migraine based on comorbidity profiles. These classes show differences in demographic and headache features not used to form the classes. Subsequent research will assess prognostic and biologic differences among the classes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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