Living with migraine during a pandemic

Professor Buse reported results of the Migraine Clinical Outcome Assessment System (MICOAS) qualitative study on the impact of the COVID-19 pandemic on people living with migraine (N=40), which were presented as a poster at #AHSAM21.¹

COVID-19 has had both positive and negative impact on people with migraine

Negative impact of the pandemic

Participants in the interviews reported negative impact in three areas of life including barriers to receiving migraine treatment, increased migraine attack frequency and severity, and additional stressors due to the COVID-19 pandemic.¹

A disruption to delivery of face-to-face procedures was also noted in a study of patients with chronic migraine or high frequency episodic migraine in Spain (N=67).² The involuntary delay of onabotulinumtoxin A injections was associated with increase in frequency and severity of migraine attacks in web-based surveys of people with migraine in Spain (N=222) and Kuwait (N=1018), with 10% of patients transforming to chronic migraine in Kuwait.^3,4 Nearly 80% of patients in Kuwait reported having symptoms of anxiety and/or depression.⁴

For some people with migraine, the pandemic has reduced access to treatment and led to increased migraine frequency and severity

Positive impact of the pandemic

In contrast, some participants in the MICOAS study reported an improvement in access to care through telemedicine and a general positive impact of the pandemic on general life, including reduced exposure to triggers, fewer concerns about the need to engage in activities outside the home and reduced guilt over cancelling social events with friends and family.¹

For other people with migraine, the pandemic has reduced exposure to triggers and other stressors

In an observational study from the Italian Headache Registry (RICe) of 433 people with migraine, a reduction in headache frequency and intensity during quarantine was noted which correlated with the number of stay-at-home days.⁵ However, there was a tendency towards worsening of headache frequency in northern Italy where the pandemic was very impactful.⁵ Conversely, a significant reduction of migraine symptoms intensity and frequency was observed in pediatric patients during the lockdown phase in northern Italy.⁶

In conclusion, Professor Buse said that the impact of the pandemic and social distancing from the point of view of people with migraine has resulted in both positive and negative experiences. For some patients, many additional stressors were experienced resulting in increased attack frequency. Conversely, for other people a reduction in outside pressures resulted in more positive experiences, with increased sleep, consistent schedules a general slowing down of activities and fewer social pressures.

Biobehavioral therapies and practices are essential for coping and maintaining balance at any time, especially during times of prolonged stress