Abstracts

Migraine and Psychiatric Comorbidities in Patients With Epilepsy

Abstract number : 3.268
Submission category : 6. Comorbidity (Somatic and Psychiatric)
Year : 2018
Submission ID : 506540
Source : www.aesnet.org
Presentation date : 12/3/2018 1:55:12 PM
Published date : Nov 5, 2018, 18:00 PM

Authors :
Mia Minen, NYU Langone Health; Sandra India, Sackler Institute, NYU School of Medicine; Jacqueline A. French, New York University Comprehensive Epilepsy Center; Andres M. Kanner, University of Miami, Miller School of Medicine; John Barry, Stanford Univers

Rationale: Migraine and epilepsy are common chronic and paroxysmal neurological disorders but their comorbidity is understudied. Little is known about the profile of patients with first onset seizure regarding their migraine and related psychiatric history. We aim to evaluate migraine and psychiatric comorbidities common in epilepsy patients such as depression, anxiety and suicidality. Methods: Using data from the Human Epilepsy Project (HEP), a prospective multicenter study of patients with newly diagnosed focal epilepsy, we examined migraine and psychiatric comorbidities at baseline. The diagnosis of migraine was made based off a previously used validated screen for migraine using the American Migraine Prevalence and Prevention (AMPP) study questionnaire. Univariate descriptive analyses were performed on epilepsy patients comparing those with migraine to those without migraine. Among those with migraine, we assessed for differences in migraine with aura (MWA) and migraine without aura (MOA). Using multivariable analyses (ANCOVA), we assessed for differences in depression and anxiety scores (CES-D, N-DDIE, and GAD-7) between epilepsy patients with migraine and without migraine, controlling for demographic variables (age, education, gender, employment, race, and ethnicity). Additionally, we examined whether there were differences in psychiatric comorbidities in epilepsy patients with MWA and MOA. Results: Of the 450 patients with epilepsy in the study, 82 individuals (18.2%) had a diagnosis of migraine, and 53 individuals (64.6%) of those were MWA. 59.3% were women. Mean age was 33 years old. Mean age of seizure onset was at 31.5 years old for epilepsy patients with migraine. Mean MIDAS score for epilepsy patients with migraine was 11.6 (SD: 19.1) (14.6 for aura, 6.0 for without aura). In our ANCOVA multivariable analyses, we observed a statistically significant difference (P=0.013) in depression scores (CES-D) between epilepsy patients with migraine (Mean=14.4) and those without migraine (Mean =10.7). We also observed a statistically significant difference between MWA and MOA in depression scores N-DDIE (Mean no aura=9.8, Mean aura=12.3; P=0.020), and CES-D (Mean no aura =10.3, Mean aura=16.6; P=0.036). Epilepsy patients with younger age had higher suicidality scores, controlling for covariates (P=0.025). Conclusions: In a sample of patients with newly diagnosed focal epilepsy, 18% had migraine, and it was predominantly MWA. The epilepsy patients with migraine had higher depression scores compared to those without migraine. Epilepsy MWA had higher depression scores compared to MOA. Clinicians should be alert for signs of depression in epilepsy patients with migraine. Given the paucity of studies evaluating the comorbidity between epilepsy, migraine, and other associated psychiatric conditions, further studies should be performed to better assess these relationships<./p>